Electronic stethoscope with accessories

ABSTRACT

Electronic stethoscopes may have various accessories, modular components, and various configurations for powering the various components and accessories of the electronic stethoscope. In one embodiment, an electronic stethoscope apparatus includes a microphone configured to generate an electrical signal in response to received sound from a living subject; amplification circuitry; a speaker operably coupled to the amplification circuitry to output the electric signal after amplification; and a power supply configured to power the amplification circuitry. Circuitry for advanced signal processing may also be included, such as noise cancelling circuitry. The electronic stethoscope may also include removable electronic modules for wired or wireless headphones, battery packs, lights, and/or an electronic device for implementing the percussive method. An electronic stethoscope may also include components for implementing a laser enhanced stethoscope that can be used to pick up sounds from the surface of a living subject without making direct contact with the living subject.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims the benefit of U.S. Provisional PatentApplication No. 62/786,816, filed Dec. 31, 2018, the content of which ishereby incorporated by reference in its entirety.

BACKGROUND

The present disclosure relates to electronic stethoscopes andaccessories for electronic stethoscopes.

A stethoscope is a medical device that may be used for auscultation, orthe listening to of internal sounds of a living subject such as ananimal or human body. Stethoscopes are often used by healthcareprofessionals to listen to lung, heart, artery, vein, intestine, and/orbowel sounds. Such use can help a healthcare professional identify cluesfor making a diagnosis of various illnesses or conditions. Stethoscopesare in such widespread use among healthcare professionals, that thestethoscope is often seen as a symbol of healthcare and/or healthcareprofessionals.

BRIEF SUMMARY

The following descriptions of examples of methods and systems are notintended to limit the scope of the description to the precise form orforms detailed herein. Instead, the following description is intended tobe illustrative only and others may still follow and implement theteachings herein.

The instant disclosure provides for electronic stethoscopes with variousaccessories, modular components, and various configurations for poweringthe various components and accessories of the electronic stethoscope.For example, an electronic stethoscope may have electronic componentsthat pick up sounds that can be processed, filtered, amplified, etc., toget a better or different sound than an acoustic stethoscope. In otherexamples, an electronic stethoscope as described herein may be anacoustic stethoscope that has additional electronic components, eitherfor picking up sounds from a subject (e.g., for use as a stethoscope) orfor other purposes (e.g., accessories to the stethoscope). For example,an accessory of a stethoscope may include a light that can be attachedto or integral to the stethoscope for use in clinical diagnoses. Inanother example, accessories for listening to an electronically sensedsound may be part of a stethoscope, such as wired or wirelessheadphones. Another accessory may be a percussive device that causes apercussive force to impact the surface of a subject, which may be usedin clinical diagnoses to determine density of an underlying structure.In other examples lasers may be used to accomplish, augment, orsupplement the detection of vibrations on the surface of a subjectwithout physical contact with that subject.

In one embodiment, an electronic stethoscope apparatus comprises: amicrophone configured to generate an electrical signal in response toreceived sound from a living subject; amplification circuitry operablycoupled to the microphone and configured to amplify the electric signalgenerated by the microphone; a speaker operably coupled to theamplification circuitry and configured to output the electric signalafter amplification; and a power supply configured to power theamplification circuitry.

In one embodiment, a light apparatus comprises: a light; a switch toturn the light on or off; and a clipping mechanism configured to attachthe light apparatus to a bell portion of a stethoscope, wherein theswitch is accessible while the light apparatus is attached to the bellportion.

In one embodiment, an apparatus for applying a percussive force to aliving subject comprises: a membrane having a first surface and a secondsurface, wherein the first surface is opposite the second surface; and alinear actuator configured to move a plunger linearly in response toapplication or removal of an electrical signal, wherein the linearactuator is configured to move the plunger such that the plunger impactsthe first surface of the membrane and the membrane is configured totransmit a percussive force from the first surface to the second surfaceas a result of the plunger impacting the first surface of the membrane.

In one embodiment, a method is disclosed comprising: positioning anapparatus for applying a percussive force at a first location of aliving subject; positioning an acoustic sensor at a second location ofthe living subject; applying a first electrical signal to a linearactuator causing a plunger to move linearly such that it impacts a firstsurface of a membrane, wherein the membrane comprises a second surfaceopposite the first surface and the membrane transmits a percussive forcefrom the first surface to the second surface and into the living subjectas a result of the plunger impacting the first surface of the membrane;and generating, by the acoustic sensor, a second electrical signalindicative of a response of the living subject to the plunger impactingthe membrane and transmitting the percussive force into the livingsubject.

In one embodiment, an apparatus for measuring vibrations of a surface ofa living subject comprises: an emitter configured to emit a laser beamdirected at the surface of the living subject, wherein the laser beam isconfigured to interact with the surface of the living subject such thata reflected laser beam reflects from the surface of the living subject,and further wherein the reflected laser beam has differentcharacteristics from the laser beam at least in part due to theinteraction with the surface of the living subject; a detectorconfigured to detect the reflected laser beam that is reflected from thesurface of the living subject; and a processor configured to process thedetected reflected laser beam to determine vibrations of the surface ofthe living subject.

In one embodiment, a method is disclosed for measuring vibrations of asurface of a living subject comprising: emitting a laser beam directedat the surface of the living subject, wherein the laser beam isconfigured to interact with the surface of the living subject such thata reflected laser beam reflects from the surface of the living subject,and further wherein the reflected laser beam has differentcharacteristics from the laser beam at least in part due to theinteraction with the surface of the living subject; detecting thereflected laser beam that is reflected from the surface of the livingsubject; and processing the detected reflected laser beam to determinevibrations of the surface of the living subject.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other objects, features, and advantages of thedisclosure will be apparent from the following description ofembodiments as illustrated in the accompanying drawings, in whichreference characters refer to the same parts throughout the variousviews. The drawings are not necessarily to scale, emphasis instead beingplaced upon illustrating principles of the disclosure.

FIG. 1 illustrates a stethoscope according to some embodiments of thedisclosure.

FIG. 2 is a schematic diagram of electronic stethoscope components withan external speaker module according to some embodiments of thedisclosure.

FIG. 3 is a schematic diagram of electronic stethoscope components witha wireless module according to some embodiments of the disclosure.

FIG. 4 illustrates a light accessory for a stethoscope according to someembodiments of the disclosure.

FIG. 5 illustrates a clipping mechanism with flexible legs for anelectronic accessory of a stethoscope according to some embodiments ofthe disclosure.

FIGS. 6A and 6B illustrate a clipping mechanism having a spring attachedto a leg for an electronic accessory of a stethoscope according to someembodiments of the disclosure.

FIGS. 7A-7D illustrate a clipping mechanism for an electronic accessoryof a stethoscope according to some embodiments of the disclosure.

FIGS. 8A-8D illustrate a clipping mechanism for an electronic accessoryconfigured to fit different sized stethoscopes according to someembodiments of the disclosure.

FIG. 9 is a schematic diagram of a percussive device according to someembodiments of the disclosure.

FIG. 10 is a schematic diagram of a percussive element of a percussivedevice according to some embodiments of the disclosure.

FIG. 11 is a flow diagram illustrating a method for using a percussivedevice according to some embodiments of the disclosure.

FIG. 12 is a schematic diagram of a laser detection device for measuringvibrations of a surface of a living subject according to someembodiments of the disclosure.

FIG. 13 is a flow diagram illustrating a method for measuring vibrationsof a surface of a living subject according to some embodiments of thedisclosure.

FIGS. 14A and 14B illustrate another example of a light accessoryaccording to some embodiments of the disclosure.

FIG. 15A illustrates a cross-sectional perspective view of a cover ofthe example light accessory of FIGS. 14A and 14B according to someembodiments of the disclosure.

FIG. 15B illustrates a cross sectional view of another embodiment of acover of a light accessory according to some embodiments of thedisclosure.

FIG. 16 illustrates a circuit schematic of an example light accessoryaccording to some embodiments of the disclosure.

FIG. 17 illustrates a circuit schematic to step up voltage for anexample light accessory according to some embodiments of the disclosure.

FIGS. 18A and 18B illustrate an electronic stethoscope with in-earheadphones according to some embodiments of the disclosure.

FIGS. 19A-19C illustrate an electronic stethoscope with over-earheadphones according to some embodiments of the disclosure.

DETAILED DESCRIPTION

The present disclosure will now be described more fully hereinafter withreference to the accompanying drawings, which form a part hereof, andwhich show, by way of illustration, certain example embodiments. Subjectmatter may, however, be embodied in a variety of different forms and,therefore, covered or claimed subject matter is intended to be construedas not being limited to any example embodiments set forth herein;example embodiments are provided merely to be illustrative. Likewise, areasonably broad scope for claimed or covered subject matter isintended. Among other things, for example, subject matter may beembodied as methods, devices, components, or systems. Accordingly,embodiments may, for example, take the form of hardware, software,firmware or any combination thereof (other than software per se). Thefollowing detailed description is, therefore, not intended to be takenin a limiting sense.

Described herein are electronic stethoscopes with various accessories,modular components, and various configurations for powering the variouscomponents and accessories of the electronic stethoscope. For example,an electronic stethoscope may have electronic components that pick upsounds that can be processed, filtered, amplified, etc. to get a betteror different sound than an acoustic stethoscope. In other examples, anelectronic stethoscope as described herein may be an acousticstethoscope that has additional electronic components, either forpicking up sounds from a subject (e.g., for use as a stethoscope) or forother purposes (e.g., accessories to the stethoscope). For example, anaccessory of a stethoscope may include a light that can be attached toor integral to the stethoscope for use in clinical diagnoses. In anotherexample, accessories for listening to an electronically sensed sound maybe part of a stethoscope, such as wired or wireless headphones. Anotheraccessory may be a percussive device that causes a percussive force toimpact the surface of a subject, which may be used in clinical diagnosesto determine density of an underlying structure. In other exampleslasers may be used instead of or in addition to stethoscopes fordetecting vibrations on the surface of a subject without physicalcontact with that subject.

The various accessories and electronic stethoscope components may beused and implemented in different ways, including as modular componentsfor either an electronic stethoscope or an acoustic stethoscope. Themodularity of the various components described herein allow a user toadd, subtract, replace, etc. various modules as described herein toimprove the functionality of a stethoscope as desired by the user. Inthis way, a user may add a particular module to their stethoscope(whether electronic or acoustic) that gives the functionality theydesire. This advantageously allows a user to only select modules theywant, making those features more affordable than having to buy astethoscope with components/features the user does not want or would notuse. In other words, a user may tailor their stethoscope to their uniquedesires and needs using various modules described herein. In addition,modules may be replaced when they become worn or fail, modules may beupgraded when the user has more funds or desires additionalfunctionality, and better modules may be developed over time andsubstituted by users over time to improve their electronic stethoscopewithout buying a completely new one. In various embodiments, multipleworking modules of the same type may be used. For example, a first lightmodule may be used while a second light module's battery is charging. Inthis way, modules may be swapped out for one another so that there is nodowntime for the medical professional waiting, for example, for amodule's battery to charge. A module may also be swapped out so thatsomeone other than a doctor or healthcare provider may change out thebattery instead of the doctor or healthcare provider. This allows thedoctor or healthcare provider to focus on giving patient care ratherthan swapping out module batteries. In another example, modules may besterilized or otherwise cleaned between uses. If multiple modules of thesame type are used and available, a used/dirty module can be swapped outfor a different, clean one so that there is no downtime. In other words,a first module may be used while a second module is cleaned, and afteruse of the first module it can be swapped out for the second module orstill a third module that is already clean.

The various modular components described herein may also be used toenhance an electronic stethoscope or an acoustic stethoscope. Forexample, a light accessory, a battery pack, or other module as describedherein may be used with either an electronic or acoustic stethoscope.Other modules may be used to enhance an acoustic stethoscope and turn itinto an electronic stethoscope (e.g., install a module with amicrophone, a module that includes a speaker or transmits to headphones,etc.). Some modules described herein may also be used with or withoutuse of a stethoscope, such as the light accessory, the percussivedevice, and/or the laser enhanced listening methods described herein.Some modules may also be used in conjunction with one another, whetheror not a stethoscope is also used. For example, a battery pack modulemay be used to power various modules/accessories whether or not astethoscope is used. In another example, a battery pack may be used topower a light accessory, a percussive device, and or a laser enhancedlistening method. In another example, a speaker or headphone module(e.g., as described below with respect to FIGS. 2 and 3) may be usedwith a percussive device and/or the laser enhanced listening methods,whether or not a stethoscope is used. Accordingly, various modules andaccessories described herein may be used with and/or attached to astethoscope (whether electronic or acoustic), may be used with oneanother, and/or may be used independently of a stethoscope. Suchmodularity and customization provides significant advantages for cost tothe user, convenience and ease of use, portability, and many otheradvantages as described herein.

Various deficiencies of a standard acoustic stethoscope exist, which maybe addressed by the various embodiments described herein. For example,ambient and background noise are a significant part of the auditoryinformation picked up by an acoustic stethoscope. The tubes of astethoscope may also be sources of ambient noise, which may corrupt adesired output. The physical form and materials of the acousticstethoscope arbitrarily modify the information present at the skinsurface which results in a lossy process for capturing sound data.Information may therefore be lost and the actual vibrations of the skinmay be distorted.

FIG. 1 illustrates an acoustic stethoscope 160, which may be enhancedwith various electronic components, accessories, etc. according to someembodiments of the disclosure. The stethoscope 160 includes a headsetwith ear pieces 162. The ear pieces 162 may be inserted into ahealthcare professional's ears for performing auscultation of a livingsubject, such as a human or animal. A drum 166 includes a diaphragm (notvisible in FIG. 1), which can be placed on the surface of the livingsubject. When the diaphragm is placed on the surface of the livingsubject, diaphragm is placed on the patient, sounds from the bodyvibrate the diaphragm, creating acoustic pressure waves which travel uptubing 168 to a listener's ears through the ear pieces 162.

A bell 164 opposite the drum 166 and diaphragm is concave in shape witha hole in the center, such that if the bell 164 is placed on the livingsubject, typically only the outer portion of the bell 164 would contactthe living subject. In such an orientation, vibrations of the skin ofthe living subject directly produce acoustic pressure waves traveling upto the listener's ears through the tubing 168. The bell 164 typicallytransmits lower frequency sounds than the diaphragm of the drum 166. Oneside of a stethoscope may be used more often by certain healthcareprofessionals or for certain diagnostic purposes. Thus, certainaccessories as described herein may be implemented according to suchpreferences or use patterns. As just one example, the diaphragm may beused by some healthcare professionals more often, so an accessory for astethoscope such as a light may be configured to fit onto and/or intothe bell 164 portion of the stethoscope. Additionally, the light may beremovable from the bell 164 of the stethoscope 160 so that the bell 164may still be used while the light is detached. In various embodiments,accessories may be attached to the stethoscope 160 so that no functionalpart of the stethoscope 160 (e.g., the diaphragm, the bell 164, the earpieces 162) is blocked from use while the accessory is attached to orintegrated in the stethoscope 160.

In various embodiments, the stethoscope 160 may also have otherelectronic components. For example, the stethoscope 160 may be modifiedto include electronic components, may include electronic components thatare not visible in FIG. 1, and/or may be compatible with accessoryelectronic components that fit and/or are used with the stethoscope 160as described herein.

Some electronic components may be configured as a module that is used tomodify an existing stethoscope. For example, additional signalprocessing modules may be added to an electronic stethoscope. In anotherexample, signal processing modules, speaker/headphone modules (e.g., asdescribed below with respect to FIGS. 2 and 3), and/ormicrophone/detection modules may be implemented on an existing acousticstethoscope to give it electronic stethoscope capabilities.

A microphone module may also be implemented in various ways in anexisting acoustic stethoscope. For example, a microphone module may comewith instructions for installing it into an existing acousticstethoscope. The installation may occur in various ways. For example, amicrophone module with instructions for how to embed an acoustic orificethat includes the microphone into the tubing of a stethoscope may beprovided. Instructions may also include steps for cutting or otherwisemodifying the tubing to install a microphone module. For example, asmall hole or port may be put in the tubing according to includedinstructions or tubing may be cut so that a microphone module is splicedin line into the tubing. A module may also be a microphone that surfacemounts onto the tubing of the stethoscope. A microphone module may alsobe inserted into the bell of the stethoscope. A microphone module mayalso be inserted between components of an existing stethoscope. Forexample, the tubing connected to the bell may be disconnected to inserta microphone module. After inserting the microphone module, the tubingand the bell may be reconnected, or the tubing and the bell may bothconnect to the microphone module such that the microphone module is nowin between the bell and the tubing. Similarly, a microphone module maybe inserted between other components, such as the tubing and the earpieces of a stethoscope, or in any other location of the stethoscope.

FIG. 2 is a schematic diagram of electronic stethoscope components 200with an external speaker module 206 according to some embodiments of thedisclosure. For example, an electronic stethoscope may include amicrophone that generates an electrical signal in response to receivedsound from a living subject. The sound generated may be an analog signalfrom a standard stethoscope head at 202, for example. The microphone maybe included in circuitry of an electronic stethoscope main unit 204, forexample.

As just one example, the microphone and any other circuitry of theelectronic stethoscope main unit 204 may be embedded into tubing (e.g.,the tubing 168 of FIG. 1) of a stethoscope connected between a diaphragmand an ear piece (e.g., one or both of the ear pieces 162 of FIG. 1). Inthis way, sound picked up by the diaphragm that passes into the tubingcan also be detected by the microphone. In some embodiments, some or allcomponents of the electronic stethoscope main unit 204 may be located inother parts of a stethoscope than the tubing, and some or all of thecomponents may be removable from the stethoscope without affecting thefunctioning of the acoustic aspects of the stethoscope.

In various embodiments where components of the electronic stethoscopemain unit 204 are installed in the tubing, the tubing allows acousticsound waves to travel from the diaphragm to the ear piece even thoughthe stethoscope also has a microphone and/or other electroniccomponents. In this way, the microphone does not impede the acousticsound waves from traveling within the tubing. In other words, themicrophone may be spliced inline of the tubing so as not to impedenormal acoustic use. Similarly, if components such as the microphone arelocated within a drum, bell, or other part of a stethoscope, thoseelectronic components may similarly be configured such that they do notimpact the use of the stethoscope as an acoustic stethoscope. In variousembodiments, an electronic stethoscope may have an electrical componentthat converts vibrations into electrical signals instead of a drum andmembrane of an acoustic stethoscope.

An electronic stethoscope as described herein may also includeamplification circuitry operably coupled to the microphone andconfigured to amplify the electric signal generated by the microphone.The amplification circuitry may be part of the electronic stethoscopemain unit 204, an external speaker module 206, or both. As just oneexample, amplification circuitry may be located within the electronicstethoscope main unit 204 and in the external speaker module at a finalspeaker amplifier stage 210.

A speaker 212 is operably coupled to the amplification circuitry (e.g.,the final speaker amplifier stage 210) and configured to output theelectric signal after amplification. In this way, the sound may beoutput for a user to hear. In FIG. 2, the speaker 212 is an externalspeaker that may be heard by anyone in the vicinity of the speaker 212,such as the patient themselves, the family of the patient, a healthcareprofessional, a healthcare student, and/or any other person. In variousembodiments, the electronic stethoscope components 200 may include otheror additional speaker types, such as wireless speakers or headphones,wired headphones, etc. Examples of different headphones are shown in anddescribed below with respect to FIGS. 18A, 18B, and 19A-19C.

FIGS. 18A and 18B illustrate an electronic stethoscope 1800 with in-earheadphones according to some embodiments of the disclosure. Inparticular, the electronic stethoscope 1800 is an example of astethoscope with headphones integrate into the stethoscope itself. Forexample, ear pieces 1802 and 1803 of the electronic stethoscope 1800each include an in-ear earbud or headphone 1804 and 1805 that may beinserted into the ears of a user of the electronic stethoscope 1800. Theearbuds 1804 and 1805 may be more comfortable than standard ear piecesof traditional stethoscopes, as they may be formed out of softermaterials. A signal may be transmitted to the earbuds 1804 and 1805through a wire 1806 so that audio may be output by the earbuds 1804 and1805. In the electronic stethoscope 1800, the wire 1806 passesinternally through the tubing of the electronic stethoscope. However, invarious embodiments, wiring may be external to the tubing, integratedinto a wall of the tubing, or a signal may be transmitted wirelessly tothe earbuds 1804 and 1805 such that the wire 1806 or other wiring is notused. The earbuds 1804 and 1805 may be, for example, the speaker 212 ofFIG. 2 or may receive a signal that is the same as or similar to thesignal output to the speaker 212 of FIG. 2. If the earbuds 1804 and 1805are configured to receive a wireless signal, the earbuds 1804 and 1805may receive a wireless signal, for example, from a wireless module 306of FIG. 3 (further described below). FIG. 18B shows an enlarged view ofthe ear piece 1803 and the earbud 1805 of the electronic stethoscope1800.

FIGS. 19A-19C illustrate an electronic stethoscope 1900 with over-earheadphones 1902 and 1904 according to some embodiments of thedisclosure. The electronic stethoscope 1900 includes external wiring1906 and 1907 to which audio signals may be transmitted to theheadphones 1902 and 1904, respectively. Similar to the electronicstethoscope 1900 of FIGS. 18A and 18B, various embodiments using theheadphones 1902 and 1904 may use internal wiring within the tubing,wiring integrated into the tubing wall, or may use wireless signals totransmit audio signals to the headphones 1902 and 1904. Each of theheadphones 1902 and 1904 each includes a clip 1903 and 1905,respectively. The clips 1903 and 1905 allow a user to fit the headphones1902 and 1904 over a user's ears, thereby securing both the headphones1902 and 1904 and the electronic stethoscope to the user. The clips 1903and 1905 are shown in more detail in FIG. 19B, and the headphone 1902 isshown attached to a user's ear using the clip 1903 in FIG. 19C.

FIGS. 18A, 18B, and 19A-19C show just two examples of speakers orheadphones that may be implemented according to the various embodimentsdescribed herein to output audio with a speaker, headphone, etc. Othertypes of headphones, speakers, other audio output devices, or anycombination thereof may be used to output an audio signal in variousembodiments described herein. Headphones, such as those described inFIGS. 18A, 18B, and 19A-19C, may also be beneficial to a user from acomfort and ease of use standpoint when using the electronicstethoscopes described herein. For example, the ear pieces in standardstethoscopes are often hard and may be uncomfortable in a user's ears.Softer in-ear headphones or headphones that fit over and/or around auser's ears may relieve any pain or discomfort caused by hard ear piecesof traditional stethoscopes.

The external speaker module 206 also includes an external microphone 216that picks up ambient noise and sound output by the speaker 212. Asignal picked up by the microphone 216 is used by ambient noisecancellation signal processing 208 to filter ambient noise and/or soundoutput from the speaker 212 that may be picked up by the microphone ofthe electronic stethoscope main unit. This filtering may be done beforethe final speaker amplifier stage 210 to further reduce feedback fromthe speaker. The microphone 216 is considered external because it is notwithin the tubing, drum, bell, or ear pieces of the stethoscope andtherefore does not directly pick up the acoustic signals detected usingthe diaphragm/drum or bell of the stethoscope. The ambient noisecancellation signal processing 208 may, in various embodiments, includeother circuit components, such as other filtering and/or amplificationcomponents. Filtering/processing components of the electronicstethoscope may also cause the outputted signal to match or approximatea traditional acoustic stethoscope tube audio response. In this way,healthcare professionals may hear a similar sound to what an acousticstethoscope would generate. In some embodiments, the signal outputtedmay match or approximate an acoustic stethoscope response. For example,the signal outputted may match the acoustic stethoscope output exceptfor a magnitude or volume of the signal so that a healthcareprofessional could hear the output better. In another example, thesignal processing may attempt to duplicate the acoustic stethoscopeoutput except transpose the frequency of the output (e.g., lower a highfrequency signal, raise a low frequency signal, move the output to afrequency band where there is less noise) to make it easier for ahealthcare professional to hear the output.

The electronic stethoscope components 200 also include a power supplyconfigured to power the amplification circuitry. The power supply mayalso power any signal processing components, the microphone,transceivers for wireless connectivity, etc. In FIG. 2, the externalspeaker module 206 is powered by a battery (not pictured). The powerfrom the battery also supplies power to the electronic stethoscope mainunit 204 through a powered input/output (I/O) connection. The externalspeaker module 206 also has a second powered I/O output 214 so thatother devices, accessories, etc. as described herein may also be poweredfrom the battery of the external speaker module 206 in a powered I/Odaisy chain. Other devices, accessories, etc. may also be configured tohave a battery with powered I/O connections. In various embodiments,some devices, accessories, etc. may not have a battery or other powersource, but may receive power through a powered I/O connection for useby the device, accessory, etc. and may pass on power through a secondpowered I/O connection to other devices, accessories, etc. In this way,various devices may be interchangeable and/or used with the electronicstethoscope components 200 of FIG. 2. The various components,accessories, devices, etc. disclosed herein may be modular such thatthey may be removed from the stethoscope, interchanged for otherdevices/accessories, or compatible for other devices/accessories to beadded. For example, aspects of the electronic stethoscope main unit 204may be embedded in a stethoscope such that they are not easily removablefrom the stethoscope. However, a clipping mechanism of the electronicstethoscope main unit 204 may be connectable (through either a wired orwireless connection) to the external speaker module 206, such thatconnecting the two causes them to work together. Otheraccessories/devices may also connect to the electronic stethoscope mainunit 204 in place of or in addition to the external speaker module.

Other configurations are also contemplated for the power supply. Forexample, a battery or other power source may be in the electronicstethoscope main unit 204 instead of or in addition to the externalspeaker module. In this way, the electronic stethoscope main unit 204may be powered by its own power source or battery. The power source orbattery of the electronic stethoscope main unit 204 may also power theexternal speaker module 206 when the two are connected, particularly ifthe external speaker module does not have its own power supply. Thepower from the battery of the electronic stethoscope main unit 204 mayalso pass through the external speaker module 206 to power otherdevices/accessories through the second powered I/O output 214. Invarious embodiments, a power supply may be some other supply than abattery, or may be a battery combined with some other supply. Forexample, a solar cell may provide power and/or charge a battery. Asanother example, the power supply may be a wall supplied power that theelectronic stethoscope and/or accessory is plugged into.

In various embodiments, a power supply such as a battery may be aseparate modular unit from other modular units such as the externalspeaker module 206. For example, a battery module may plug into thesecond powered I/O output 214 of the external speaker module 206 andpower both the external speaker module 206 and the electronicstethoscope main unit 204. In various embodiments, a battery or otherpower supply may be insertable into various modules. For example, abattery may be part of the external speaker module 206, but may beremovable for charging, replacement, etc. In various embodiments, theexternal speaker module may be plugged into a wall supplied power outletto charge a battery of the external speaker module. In variousembodiments, a battery may not be removable from a module. For example,a module may be disposable/replaceable such that the module is disposedof and/or replaced when it runs out of battery or after a predeterminednumber of uses (or after a single use). Accordingly, the power supplymay be configured in various ways as described herein.

In various embodiments, an entire electronic stethoscope may bedisposable and/or configured for single use. In medical contexts, manytools and other equipment is used only once so that the tool does notneed to be sterilized after use, it may instead be disposed of Incontexts where components of or an entire electronic stethoscope isconfigured for single use, components of the electronic stethoscope maybe specifically configured for single use. For example, components maybe less durable because the components must only be used once, batterylife of batteries may be shorter as the battery needs to last only once,etc. For example, a coin cell or single AAA battery may be used in adisposable electronic stethoscope instead of a rechargeable battery orsome other external power source. In another example, certain componentsmay be made of plastic instead of metal (e.g., for an ear piece,headphone, clip, etc.). Components may also be designed such that theydo not need to withstand typical sterilization procedures if thecomponent or electronic stethoscope is only configured for a single use.For example, components may not need to be sealed as tightly to preventingress/egress of dust, fluid (air or liquid), etc. if the accessory ormodule is designed for a single use. Accordingly, components of and/oran entire electronic stethoscope as described herein may be configuredfor multiple or single (disposable) use. The packaging for a disposableelectronic stethoscope may also vary as compared to a multiple useelectronic stethoscope. Features of a disposable or single useelectronic stethoscope may also be designed to be less complex. Forexample, software of a single use may be configured to provide for lessfeatures than a multiple use electronic stethoscope. For example,instead of providing a continuum of volume settings using touchsensitive buttons, a predetermined number of discreet volume levels or asingle volume level may be used to reduce the complexity of both thesoftware and/or hardware used in a single use electronic stethoscope. Anautomatic gain circuit that provides automatic volume control based onconditions (e.g., ambient noise levels) may also be used in anelectronic stethoscope. That automatic gain circuit may be used in lieuof manual volume controls in a single use electronic stethoscope toreduce complexity. In some embodiments, the automatic gain circuit maybe used in multiple use electronic stethoscopes along with a manualcontrol aspect, and the automatic gain circuit may be eliminated in asingle use stethoscope in favor of manual controls to reduce complexityin the single use electronic stethoscope.

The second powered I/O output 214 may also provide data output from theexternal speaker module 206. For example, the signal from the electronicstethoscope main unit 204 (before and/or after processing at the ambientnoise cancellation signal processing 208 and/or final speaker amplifierstage 210) may also be output through the second powered I/O output 214.This output may go to a computer/database/server for storage, furtheranalysis/processing, a remote telemedicine healthcare provider, etc. Theoutput may also be sent to other modules, such as a wirelesstransceiver, advanced filtering circuitry, or any other type of modulardevice. In various embodiments, the electronic stethoscope main unit 204and/or the external speaker module may provide additionalconnectors/ports (either wired or wireless) for additional listeners,headphones, remote listening devices (e.g., not in the same room as theliving subject), etc. Outputs to additional listeners may be helpful ina teaching environment, where it is helpful for multiple students,residents, etc. to hear an output from an electronic stethoscope orother module described herein. Outputs to additional listeners may alsobe valuable for remote or telemedicine care. Outputs may also be to aspeaker, e.g., mounted in a classroom or other room, so that multiplelisteners can hear the output. If an external speaker is in the sameroom where the electronic stethoscope is used, the audio processing ofthe electronic stethoscope may filter out noise and/or feedback from theexternal speaker.

Various electronic stethoscope components and/or modules may also beconfigured such that a device is powered off (e.g., power is not used)when a module is not present. This may conserve battery. For example,assume the electronic stethoscope main unit 204 has a battery. If anexternal speaker module 206 (or some other module) is not plugged intothe electronic stethoscope main unit 204, the electronic stethoscopemain unit 204 will logically or physically switch off the electricalcomponents (or some of the electrical components) of the electronicstethoscope main unit 204 such that those components do not draw powerfrom the battery, conserving the battery's life. This may beaccomplished with a sensor to determine if something is plugged in(e.g., whether a headphone jack/port is plugged in or not). If apresence of a headphone connector is not sensed, the device will turnoff. Similarly, the components of the stethoscope may determine whethera wireless module, such as a headphone or speaker are connected. If not,the device will turn off. If so, the device powers on. In variousembodiments, a module (e.g., the electronic stethoscope main unit 204,the external speaker module) may also have a power switch that may beturned on and off by a user. For example, various embodiments of thelight accessory/module described herein may have a switch that turns thelight on and off, helping preserve battery life.

In various embodiments, modules and/or accessories may also go into asleep and/or standby mode to reduce power consumption from a battery orother power source. For example, in a light accessory or other accessoryor module with a user input functionality may be programmed to go into asleep and/or standby mode when the user input (e.g., on/off switch of alight accessory) has not been actuated for a predetermined period oftime. For example, touch sensitive user inputs may use larger amounts ofpower to be responsive to touch and subtle changes in a user's touch. Asdescribed herein, touch sensitive inputs may be used to adjust abrightness and/or focus of a light, for example. If a standby or sleepmode is entered into after a predetermined amount of time with no input,a light accessory for example may cease tracking the touch sensitiveaspects of the input or may reduce the sensitivity of responsivenesstouch sensitive aspects of the input. Then, when an input that requiresless power to detect (e.g., user input through an on/off switch, strongtouch to a reduced responsiveness touch sensor) is received by theaccessory it may “wake up” and transition back into a mode where it ismore sensitive and/or responsive. In this way, battery life may bepreserved by not powering certain aspects of an accessory or module thatdraw more power than other user input aspects until some input isreceived indicating that the accessory or module is being actively used.

In various embodiments, other methods and electrical components may beused to determine whether a device is in use or not. For example, amodule or electronic stethoscope component may include a motion sensor,accelerometer, or the like to determine whether the module/stethoscopeis motion and therefore likely being used. If so, the module and/orelectronic stethoscope components may be powered on. If the motionstops, or stops for a predetermined amount/threshold of time, the moduleand/or electronic stethoscope components may be turned off automaticallyby the system. In other words, sensors may be used to determine whetheran electronic stethoscope is in use. When it is in use, power isprovided to the amplification circuitry, for example. When it is not inuse power is not provided to the amplification circuitry, for example.Other sensor types than motion sensors may also be used. For example,any other type of light, heat, touch, or other type of sensor may beused to activate or turn on a device or determine whether it is likelyin use. For example, if a light sensor senses that a light in a room ison, the electronic components may be on or active assuming that theelectronic stethoscope is being used or may be in use soon, butdeactivate while the light sensor senses darkness. Other sensor typesmay be used in a similar fashion to determine whether an electronicstethoscope or component thereof is in use or likely to be in use inorder to control power consumption of the electronic stethoscope orcomponents thereof.

In another example, the determination whether an electronic stethoscopeis in use or not is made may be based on an amplitude of the electricalsignal generated by the microphone is below a predetermined threshold.That is, if the sound sensed by the microphone is loud enough or of ahigh enough magnitude, the device will be considered in use and willturn on. In this way, the device will power down, for example, if it isjust sitting in a room alone, but will switch on when people walk intalking or the stethoscope is handled such that the microphone picks upnoise of a predetermined magnitude. The stethoscope may further beconfigured to turn on if the noise lasts for a predetermined amount oftime.

FIG. 3 is a schematic diagram of electronic stethoscope components 300with a wireless module 306 according to some embodiments of thedisclosure. The electronic stethoscope components 300 of FIG. 3 includean analog signal from a standard stethoscope head 302, which may besimilar to the analog signal from a standard stethoscope head 202 ofFIG. 2. The electronic stethoscope components 300 also include anelectronic stethoscope main unit 304, which may be similar to theelectronic stethoscope main unit 204 of FIG. 2.

The wireless module 306 is connected to the electronic stethoscope mainunit 304 through a powered I/O connection similar to the powered I/Oconnections described herein with respect to FIG. 2. Accordingly, thewireless module 306 may transmit and/or receive power through itspowered I/O connections, including to and/or from the electronicstethoscope main unit 304 and/or any other module connected through asecond powered I/O output 308. In this way, various modules may bepowered by a power supply of the electronic stethoscope main unit 304,the wireless module 306, or other power supply as described herein.

The wireless module 306 in FIG. 3 is a Bluetooth wireless module, but invarious embodiments other wireless protocols may be used. The wirelessmodule 306 may include electronic components such as a wirelessconnection port 310. Various devices may connect to the wireless module306 through the wireless connection port 310. For example, wirelessheadphones may be connected to the wireless module 306 so that theoutput from the stethoscope may listened to. A computing device such asa smartphone may also connect wirelessly to the wireless module 306.Audio may be output to the smartphone through the connection to besaved, analyzed, further processed, transmitted to other computingdevices, transmitted/output to speakers and/or headphones, etc.

Other modules than those shown in FIGS. 2 and 3 are also contemplatedherein. For example, advanced audio processing modules may be utilizedto further process, filter, or analyze the audio signal picked up by anaudio sensor in the stethoscope. For example, ambient noise cancellingmay also be used in the embodiment of FIG. 3. Other modules may includediagnostic tools, such as a display that visually represents audiosignals picked up by the stethoscope. In addition, the modules disclosedherein, including audio modules such as those shown in FIGS. 2 and 3 mayalso be integrated into or removable from an electronic stethoscope.Where a module is integrated into the electronic stethoscope, the moduleis not easily removable from the electronic stethoscope by the user. Insuch embodiments, the modules may come pre-assembled and packaged tolook similar to a traditional stethoscope, as the circuitry or otherportions of the modules may be integrated into the hardware of astethoscope itself.

As another example of a module that may be used in conjunction with astethoscope (either electronic or acoustic), FIG. 4 illustrates a lightaccessory 400 for a stethoscope according to some embodiments of thedisclosure. FIG. 4 shows example components of a light accessory, butadditional, fewer, or different components may be used in other lightaccessories. The light accessory includes a mount 402 that is used toremovably attach the light accessory 400 to a stethoscope. The mount 402is a type of clipping mechanism configured to connect the lightaccessory to a stethoscope. Various clipping mechanisms are possible andsome examples are shown in FIGS. 5, 6A, 6B, 7A-7D, and 8A-8D. The mount402 is configured to attach around the outside a bell of a stethoscope,such as the bell 164 of the stethoscope 160 of FIG. 1. By attaching thelight accessory 400 to the bell of a stethoscope, the diaphragm of thestethoscope may still be used while the light accessory 400 is attached.Additionally, the bell/drum of a stethoscope end is easily held andhandled by one hand of a healthcare professional. When the lightaccessory 400 is attached to the drum/bell of the stethoscope, the lightaccessory 400 can also therefore be easily handled with the same handwithout use of a second hand, without having to switch instruments, etc.For example, if a healthcare professional is using the diaphragm portionof the stethoscope, the healthcare professional merely flips thedrum/bell portion around to use the light attached to the bell. Thelight accessory 400 also includes a switch 410 to turn the light on andoff. This switch 410 may also be manipulated by that same hand to turnthe light on and off, advantageously providing convenience and ease ofuse to the healthcare professional.

As described herein, the light accessory 400 attaches to the bell of astethoscope via the mount 402. The mount 402 may be configured to fitvarious sizes of stethoscope bells. For example, the mount 402 may bemade from a flexible rubberized plastic that can bend to fit manydifferent sizes and shapes of stethoscope. This provides a snug fit thatwill prevent the light accessory 400 from moving on the bell when thestethoscope is being used. Rubberized material may also providedampening between the stethoscope and the light accessory 400. Thisadvantageously helps prevent additional noise being transmitted into thestethoscope. For example, a switching mechanism such as the switch 410may produce a clicking noise when the light accessory 400 is turned onand off. The rubberized material absorbs some of that noise preventingit from being too loud for someone wearing the stethoscope. In anotherexample, attaching or removing the mount 402 and light accessory 400from the stethoscope may produce noise, but the rubberized materialagain helps prevent that noise from being transmitted into thestethoscope. Where the light accessory 400 is used with electronicfiltering components, those components may also filter out noise from aswitch and/or attaching/detaching the light accessory 400 from thestethoscope.

In various embodiments, other types of mounts may be utilized thatattach the light accessory 400 to a stethoscope in other ways and/or oronto other portions of a stethoscope. For example, a mount may be a clipthat attaches the light to tubing of a stethoscope, or attaches thelight to the portion between the bell and the drum such that neither ofthe bell or diaphragm are blocked from use while the light is attached.

Attached to the mount 402 is a cover 404 of the light accessory 400. Thecover may have an adhesive to attach it to the mount 402. An adhesivelayer 406 attaches the cover 404 to a spacer 408 with the built-inswitch 410 that is used to turn the light accessory on and off.Advantageously, the switch 410 is accessible to the user while the lightaccessory 400 is clipped to a stethoscope. A battery 414 fits into thespace within the spacer 408, and an adhesive layer 412 attaches acircuit board 416 to the spacer 408 opposite the cover 404. The spacer408, the battery 414, and the circuit board 416 are sized and configuredto fit together such that the circuit board 416 has leads thatelectrically connect the circuit board 416 with the battery 414 when theswitch 410 is in the on position. In this way, a light mounted on asurface of the circuit board 416 opposite the battery 414 may be poweredon when the switch 410 is in the on position. A second spacer 418 fitsover the circuit board 416, but is hollow in the middle to allow lightfrom the circuit board 416 to shine through. The spacer 418 also hasadhesive to allow a cover 420 to attach to it. The cover 420 istransparent or at least translucent to allow light from the circuitboard 416 to shine through. The light may be, for example, a lightemitting diode (LED) or any other kind of light.

The light may have additional components that allow a user to adjustlight direction, intensity, etc. Adjusting the light direction,intensity, etc. may affect battery life, how often the battery must bereplaced, charged etc. Advantageously, having an adjustable light makesfor more efficient use in different ambient lighting conditions, fordifferent clinical purposes (e.g., examining nose, throat, ear, etc.).The light may be adjusted or configured to focus on a desired region,have a particular uniform or non-uniform intensity, have a particularcolor temperature, etc.

FIG. 4 shows a battery stored directly in the light accessory 400.However, in various embodiments, the battery may be stored in adifferent portion of the stethoscope or in a different module attachableto the stethoscope and/or the light accessory 400 as described herein(e.g., through a daisy chained powered I/O connection). In variousembodiments, the light accessory 400 may also be connected through anelectrical wired connection to any other type of power supply, includinga battery in a different module, a wall supplied power, etc. In variousembodiments where the battery is in the light accessory 400, othermodules or electronic components of a stethoscope may connect to or pluginto the light accessory 400 to be powered by the battery 414 of thelight accessory 400.

The battery 414 may also be removable from the light accessory 400 suchthat the battery 414 is changeable when the battery 414 dies, or so thatthe battery 414 may be removed to be charged. In various embodiments,the battery 414 may also be non-removable from the light apparatus. Insuch embodiments, the light accessory 400 may be configured such thatthe battery 414 is rechargeable while in the light accessory 400 (e.g.,through wired or wireless charging). In various embodiments, the battery414 may not be rechargeable, but is instead designed to be disposed ofalong with the light accessory 400 after the battery 414 dies and/orafter a predetermined number of uses (e.g., in sterile or high-riskenvironments the light accessory 400 may only be used once and thendisposed of to protect patients from contamination).

FIGS. 14A and 14B illustrate another example of a light accessory 1400according to some embodiments of the disclosure. FIG. 14A illustrates anexploded view of the light accessory 1400. The light accessory 1400includes a cover 1404 with a lens, a circuit board 1402, a battery 1415,and a base 1420. The battery 1415 sits within a recess of the base 1420.In particular a positive contact 1414 portion of the battery 1415 restswithin the base 1420. Only a top edge of the positive contact 1414portion of the battery 1415 is exposed while the battery 1415 restswithin the base 1420. The top edge of the positive contact 1414 portionof the battery 1415 surrounds a battery negative 1416 surface of thebattery 1415. The battery 1415 of FIG. 14A is larger with respect to therest of the light accessory 1400 than the battery 414 of FIG. 4.

The circuit board 1402 sits on top of the battery 1415, such thatcontacts on the underside of the circuit board 1402 (not shown)electrically connect with the battery negative 1416 surface of thebattery 1415. A positive contact 1412 attached to the circuit board 1402extends down away from the circuit board 1402 to electrically connectwith the positive contact 1414 portion of the battery 1415. In this way,the circuit board 1402 may be electrically connected with the positiveand negative of the battery 1415 to power the circuit and an LED 1406.

The circuit board 1402 may include one or more touch sensors such thatthe light assembly may use a touch sensitive button to turn the LED 1406on and off. The touch sensors in FIG. 14A are represented by foursemi-circle shaped circuit components at the edge of the circuit board1402. For example, touch sensors 1408 and 1410 are shown in FIG. 14A.The touch sensors may be, for example, capacitive sensors, such thatwhen a user places a finger near the touch sensors, the touch sensorswill pick up the presence of the user's finger. In this way, the touchsensors may cause the LED 1406 to be controlled (e.g., turn on/off,adjust/control brightness, etc.). A microprocessor on the circuit board1402 may be used in combination with the touch sensors. Themicroprocessor may include RC oscillators used to sense a baselinecapacitance, and when a finger is brought in contact with or near thetouch sensitive features at the edge of the circuit board 1402, thecapacitance of those features may increase and the oscillators may thenchange in frequency. If the frequency changes more than a predeterminedthreshold, the microprocessor may determine that the sensor is beingtouched. Other types of touch sensors and/or switches may be used tocontrol the LED 1406 according to various embodiments. In variousembodiments, the touch sensors may be positioned or configured such thatthe sensors detect a presence of a user's finger when it is located onthe side of the base 1420, above the cover 1404, or both.

The circuit board 1402 may also be part of a mechanical system thatprovides pressure on the battery contacts (the positive contact 1414 andthe battery negative 1416 surface) via an elastic spring force of theplastic of the cover 1404 and the base 1420. The cover 1404 maycompressed onto the base 1420, for example during a sonic weldingprocess. In various embodiments, a sonic welding process may also jointhe circuit board 1402 and/or the touch sensors to the base 1420 and/orthe cover 1404. The sonic welding may be utilized to provide a hermeticseal of the light accessory 1400. This sealing protects the componentsinside the base 1420 and the cover 1404 (e.g., the circuit board 1402,the battery 1415, the LED 1406, the touch sensors, etc.), preventingliquid, dust, etc. ingress and/or egress into or out of the lightaccessory 1400. This also makes the light accessory easier to sterilizethan if the cover 1404 and the base 1420 were not adequately sealed. Theseal, thereby, gives the health care provider total freedom to handleand utilize the light accessory 1400, even with contaminated gloves,knowing that the light accessory 1400 can be appropriately sterilizedand re-used at a later time, regardless of use in the highest ofcontamination or infectious risk situations (e.g. management during anEbola infection/outbreak). In various embodiments, the plasticcomponents of the light accessory 1400 may be made of biodegradablematerial, such as biodegradable plastic.

The cover 1404 may also act as a lens for the LED 1406. A cross-sectionof an example lens is shown in and described below with respect to FIG.15A. The lens of the cover 1404 may be, for example, concave in shape sothat the light from the LED 1406 is focused into a beam, such that lightfrom the LED 1406 is concentrated into a narrower region than the lightwould be otherwise. The lens of the cover 1404 may be configured invarious embodiments to have different fields of illumination and/orconcentration/brightness of the light. In various embodiments, a lensmay be adjustable so that a user may adjust the field of illuminationand/or concentration/brightness of the light as desired. Other lightguiding shapes may be used in a lens. For example, an LED may be at adifferent location on the top of the circuit board 1402 instead of inthe center of the circuit board 1402 as shown in FIG. 14A. An LED mayalso be located on a side of the circuit board 1402, for example. Invarious examples, the lens may be configured to allow light to shine outthe top of the light accessory 1400 and/or the side as desired. Forexample, the base 1420 may have a transparent side so that light may beemitted from the side of the light accessory 1400. Since plastic has adifferent permeability than air, the properties of Snell's law may beutilized to cause a desired pattern of light by adjusting the lightaccessory 1400's optical geometry.

FIG. 14B additionally shows the light accessory 1400 of FIG. 14A wherethe circuit board 1402, the battery 1415, and the base 1420 areassembled and the cover 1404 is shown exploded/unassembled.

FIG. 15A illustrates a cross-sectional perspective view of a cover 1550of the example light accessory 1400 of FIGS. 14A and 14B according tosome embodiments of the disclosure. For example, the cover 1550 may bethe cover 1404 of the light accessory 1400 of FIG. 14A. The cover 1550includes a lens region 1566. The lens region 1566 is configured todirect light from a light source in a particular direction as describedherein. The lens region 1566 may be shaped in different shapes to focuslight from a light source in different ways, such as providing more orless focus, focus in a particular direction, etc. The lens region 1566in the example of FIG. 15A is a convex lens shape to focus the lighttoward a particular focal point.

The cover 1550 also includes a space 1558 with an edge 1556 configuredto fit around the edges of a circuit board, such as the circuit board1402 of FIG. 14A. The space 1558 may be configured such that the edgesof the circuit board are securely held by the edge 1556 of the cover1550, for example through a compression fit.

The cover 1550 also includes a space 1554 configured to fit around anedge of a base, such as the base 1420 of FIG. 14A. The cover 1550 andbase may be configured such that there is a compression fit between anedge 1552 and the edge of the base. In addition, as disclosed herein,the cover 1550 at the edge 1552 and the base may be sonic weldedtogether, or otherwise joined in a manner that hermetically seals thecover 1550 at the edge 1552 to the base.

The cover 1550 includes a portion 1560 that extends radially around thecover 1550 and, when assembled, sits on top an outer radial portion forthe circuit board. A raised portion 1564 toward the center of the cover1550 with respect to the portion 1560 creates a space 1562. The space1562 may provide room, for example, for components on the circuit board,such as a light source (e.g., an LED). In addition, where touch sensorsare used (e.g., as in FIGS. 14A and 14B), the portion 1560 provides anatural surface for a user to moved their finger along, which is boundedby the raised portion 1564 so that the user may easily slide theirfinger around a perimeter of the cover 1550. Furthermore, in an exampleembodiment, a lower surface of the portion 1560 is in contact with thecircuit board of a light accessory (e.g., the bottom plane of theportion 1560 rests upon touch sensitive circuit elements). Accordingly,the cover 1550 and/or the portion 1560 then comprise physical parts of acapacitor in a capacitive sensing circuit. The capacitance of such acapacitive sensing circuit varies when a finger of a user, for examplecomes in proximity to or in contact with the cover 1550 in the regionabove the touch sensitive circuit elements on the circuit board (e.g.,the region of the portion 1560).

FIG. 15B illustrates a cross sectional view of another embodiment of acover 1500 of a light accessory according to some embodiments of thedisclosure. The cover 1500 includes a lens region 1502 between lensregion boundaries 1504 and 1506. The lens region 1502 is configured todirect light from a light source in a particular direction as describedherein. The lens region 1502 may be shaped in different shapes to focuslight from a light source in different ways, such as providing more orless focus, focus in a particular direction, etc.

The cover 1500 also includes a space 1510 configured to fit around theedges of a circuit board, such as the circuit board 1402 of FIG. 14A.The space 1510 may be configured such that the edges of the circuitboard are securely held by the cover 1500, for example through acompression fit. Structural pins, including for example structural pin1508, are also included in the cover 1500. The structural pins contactportions of the circuit board to also help hold the circuit board inplace. In addition, the structural pins may contact portions of thecircuit board in locations that do not block a portion of the surfacethat emits light, and may also contact the circuit board in locationsthat do not have sensitive circuitry. The structural pins may alsoprevent the cover 1500 from deforming from contact from a user such thatportions of the cover other than the structural pins contact the surfaceof the circuit board.

The cover 1500 also includes a space 1512 configured to fit around anedge of a base, such as the base 1420 of FIG. 14A. The cover 1500 andbase may be configured such that there is a compression fit between anedge 1514 and the edge of the base. In addition, as disclosed herein,the cover 1500 at the edge 1514 and the base may be sonic weldedtogether, or otherwise joined in a manner that hermetically seals thecover 1500 at the edge 1514 to the base.

FIG. 16 illustrates a schematic of a circuit 1600 of an example lightaccessory according to some embodiments of the disclosure. The circuit1600 may exist on, for example, the circuit board 1402 of FIG. 14A. Thecircuit 1600 connects a battery, such as the battery 1415 of FIG. 14A totouch sensors, such as the touch sensors 1408 and 1410 of FIG. 14A, sothat the touch sensors may be used to turn a light source, such as theLED 1406 of FIG. 14A, on/off and/or adjust the LED. In the circuit 1600,the touch sensors are shown as buttons B1, B2, B3, and B4. Each of thebuttons B1, B2, B3, and B4 are connected to ground and to amicroprocessor 1602 at pins 10, 11, 13, and 14 respectively. Themicroprocessor 1602, may be, for example, an EFM8SB10F4G-A-QFN20microprocessor chip.

A programming portion 1604 of the circuit 1600 shows leads for a testpoint for programming the touch sensors (e.g., buttons B1, B2, B3, andB4). In other words, the programming portion 1604 of the circuit 1600provides a way to adjust how inputs from the touch sensors cause themicroprocessor 1602 to control an LED connected at pin 19 (e.g., to turnon/off and/or adjust the LED). P1 of the programming portion 1604 isconnected to a positive terminal of a voltage source, such as a batteryand P4 is connected to ground. P2 of the programming portion 1604 isconnected to pin 5 of the microprocessor 1602 and P3 is connected pin 6of the microprocessor 1602. Accordingly, these leads P1-P4 may beconnected to in order to program the microprocessor 1602 to control theLED.

Pin 4 of the microprocessor 1602 is also connected to the positiveterminal of a voltage source, such as a battery, while pins 3, 12, and21 of the microprocessor 1602 are connected to ground. Pins 1 and 20 ofthe microprocessor 1602 may be optionally connected to a step upcircuit, which is shown in and described with respect to FIG. 17.Similarly, pin 2 may also be optionally connected to the step up circuitas shown in and described with respect to FIG. 17. Pins 17 and 18 may betest points that may be soldered to in order to test outputs of themicroprocessor 1602. Such outputs may be used, for example, to test andcalibrate the sensitivity and other parameters of capacitive pushbuttons (e.g., touch sensitive buttons). Such outputs may also bevisualized on a graphical user interface of a computing or testingdevice to provide visualization of various internal variables andparameters of aspects of the system such as the push buttons.

The contact portion 1606 of the circuit 1600 shows how a voltage sourcesuch as a battery is connected. A positive terminal of a battery, J1,serves as VBAT for the circuit 1600. That is, the positive terminal ofthe battery J1 is connected to pin 4 of the microprocessor 1602 and P1of the programming portion 1604 of the circuit 1600. The negativeterminal of the battery, J2, serves as ground for the circuit 1600. Thatis, the negative terminal J2 is connected to the second pin of each ofthe buttons B1, B2, B3, and B4; pins 3, 12, and 21 of the microprocessor1602; and P4 of the programming portion 1604 of the circuit 1600.

The programming portion 1604 of the circuit may be used to program themicroprocessor 1602 to control the LED in different ways. For example,the microprocessor 1602 may be programmed to provide variable userexperiences. For example, the microprocessor 1602 may be programmed tochange/adjust the brightness of the LED by rotating the finger aroundthe periphery of the outside of a light accessory. This may beaccomplished because the touch sensor buttons B1, B2, B3, and B4 may belocated along the edge of a circuit board as shown in FIG. 14A, suchthat movement of a finger around the periphery of the light accessorymay be detected. More or less touch sensors may be utilized depending onthe size of the light accessory, the size of the touch sensors, thedesired sensitivity to movement of a finger, etc., to provide the userexperience and variable brightness adjustment desired.

FIG. 17 illustrates a schematic of a circuit 1700 to step up voltage foran example light accessory according to some embodiments of thedisclosure. The circuit 1700 may be used to step up voltage to provide ahigher voltage to one or more LEDs than some batteries, such as alithium primary battery, can provide. In addition, batteries use uptheir stored chemical energy over time, causing the battery voltage theyprovide to drop. The circuit 1700 is a step up regulator, controlled bythe microprocessor 1602, so that a higher voltage than that provided bythe battery may be controlled and supplied to a light source such as anLED. The microprocessor 1602 may control a constant voltage or aconstant current via a feedback monitoring and control loop. Bycontrolling the voltage and/or current to the LED, the brightness of anLED may also be controlled in a number of ways. For example, the voltageand or current supplied to the LED may be controlled using a variabledrive strength of the microprocessor 1602 I/O pins. For example, pins 1and 20 (the SENSE line) of the microprocessor may be used in combinationwith FET Q2 of FIG. 17 to sense the voltage and/or current applied toLED D3 in FIG. 17. The FET Q2 is controlled by a control signal LED fromthe microprocessor 1602 (connected, for example, to pin 19 of themicroprocessor 1602) and a pulse width modulated (PWM) signal (from, forexample, pin 2 of the microprocessor 1602) to vary the current and/orvoltage applied to the LED D3. When varying the voltage and/or currenton the LED D3 via the PWM signal and the step up circuit including L1and Q1, R3 provides a current sensing signal via pins 1 and 20 using themicroprocessor 1602's analog to digital converter. In variousembodiments, the circuit 1700 may also be controlled based on the typeof LED used. For example, the LED D3 may be of a variety of colors, suchas 3000K white, 5000K white, ultra violet, or blue. In variousembodiments, multiple different LEDs may be used, and they may beseparately controllable using a programmed microprocessor and varioustouch sensors or other user inputs.

FIG. 5 illustrates a clipping mechanism 500 with flexible legs 502 a,502 b, and 502 c for an electronic accessory of a stethoscope accordingto some embodiments of the disclosure. For example, the clippingmechanism 500 may be attached to the light accessory 400 of FIG. 4, orone of the modules of FIGS. 2 and 3, or some combination thereof. Inthis way, the clipping mechanism 500 can removably attach a module oraccessory to a stethoscope. Similarly, any other clipping mechanism,including the other clipping mechanism examples described herein may beused to removably attach a module or accessory to a stethoscope.

The clipping mechanism 500 includes the three flexible legs 502 a, 502b, and 502 c that are configured to fit around the bell of astethoscope. Each of the flexible legs 502 a, 502 b, and 502 c isconnected to a main body of the clipping mechanism 500 through anextension from the main body. For example, the flexible leg 502 a isconnected to the main body through an extension 504 that attaches to themain body at a point 508. A space 506 exists between the extension 504and the main body. In this way, the flexible leg 502 a is even moreflexible with respect to the main body so that the clipping mechanism500 can more easily be attached to and adhere to a stethoscope, as wellas stethoscopes of different sizes. The extension 504 extends from theflexible leg 502 a, past the flexible leg 502 c, and to the point 508such that a high degree of flexibility may be achieved. A rubberizedplastic or other flexible yet sufficiently rigid material may be usedfor the clipping mechanism 500. Such materials and the shape of theclipping mechanism advantageously allows for greater movement of theflexible legs 502 a, 502 b, and 502 c without damaging the clippingmechanism 500.

FIGS. 6A and 6B illustrate a clipping mechanism 600 having a spring 606attached to a leg 602 for an electronic accessory of a stethoscopeaccording to some embodiments of the disclosure. The spring 606 isconnected to an extension 604 that is connected to the leg 602. Thespring 606 causes the extension 604 and the leg 602 to retract in orderto advantageously fit stethoscopes of different bell sizes and shapes toget a universal or semi-universal clipping mechanism. The leg 602 can bepulled away from the main body of the clipping mechanism 600 when it isbeing attached to a stethoscope, and once it is in place the springholds the leg 602 onto the stethoscope, further secured by fixed legs610 a and 610 b (that is, they are fixed in that they are not movablyattached to a spring like the leg 602, but the fixed legs 610 a and 610b may still be flexible to some extent). The clipping mechanism 600 maybe generally made from rubberized plastic, or may be made from a morerigid plastic since the spring 606 allows for greater range of movementfor the leg 602.

FIGS. 7A-7D illustrate a clipping mechanism 700 for an electronicaccessory of a stethoscope according to some embodiments of thedisclosure. The clipping mechanism 700 has three flexible legs that canclip around a portion of a stethoscope. The clipping mechanism 700 mayalso be made from a flexible material such as rubberized plastic. Theclipping mechanism 700 may also be used to attach a module or accessoryto a stethoscope. For example, the clipping mechanism 700 may be used toattach a light accessory (e.g., as described in FIG. 4) to astethoscope, attach a battery pack to a stethoscope, or to attach anyother type of module or accessory to a stethoscope.

FIGS. 8A-8D illustrate a clipping mechanism 800 for an electronicaccessory configured to fit different sized stethoscopes according tosome embodiments of the disclosure. The clipping mechanism 800 steppeddisc can fit in different sized stethoscope bell cavities. The materialof the clipping mechanism 800 may have a rubberized/flexible/compressiveaspect to it so it can fit multiple sizes of stethoscope bells and fitsnugly. In the example of FIGS. 8A-8D, the clipping mechanism 800 hasthree different stepped discs 802, 804, and 806. In various embodiments,the clipping mechanism 800 may have different numbers of stepped discs,such as two, four, five, etc. The smaller diameter stepped disc portions(e.g., 802, 804) are designed such that for smaller stethoscopes theclipping mechanism 800 will not extend as far into the bell of thestethoscope, offering a greater chance of fit for a greater number ofdifferent sized stethoscopes. The clipping mechanism 800 is also hollowwithin the stepped disc portions, as shown by the space 808 in thecross-section in FIG. 8B. In this way, electronic components (e.g., thelight accessory 400 from FIG. 4) may exist inside the space 808,providing a small, sleek package for a modular accessory.

In various embodiments, other clipping mechanisms may be used. Forexample, some clipping mechanisms may use a surface with adhesive toattach a module/accessory to a stethoscope. Other types of clippingmechanisms may clip a module or accessory onto the hose/tubing, headset,ear pieces, drum, etc. of a stethoscope. For example, a clip may beconfigured to clip a light accessory, battery accessory, or other moduleonto the tubing of the stethoscope. Other modules and/or accessories mayalso be attached to a module/accessory already attached to thestethoscope. For example, a powered I/O connector port may be configuredto effectively secure a module/accessory to the stethoscope when it isplugged in to the port.

Another type of module/accessory that may be used with and/or attachedto a stethoscope is a percussive device. In various embodiments, apercussive device (or any other module/accessory described herein suchas a light, laser vibration detector, etc.) may be used independent of astethoscope.

Healthcare professionals traditionally have used a diagnostic techniquecalled the percussive technique, using only their hands and senses. Thepercussive technique is a method of tapping on a surface to determinethe underlying structure, and may be used in clinical examinations toassess the condition of the thorax or abdomen. A healthcare professionalperforming an examination may use such a technique of indirectpercussion by placing a spread palm against a surface of the subject,and then tapping the third finger of the hand on the surface of thesubject with a third finger of the healthcare professional's secondhand. The healthcare professional may then determine what is below thesurface (or more generally determine a relative density of what is belowthe surface) by listening to the response of the tapping. Differentsounds indicate different densities of the underlying part of thesubject, which may indicate that gas, soft organs, muscle, bone, etc.may be below the surface. There are deficiencies with this long-usedmethod. Significant training, personal experimentation, and recognitionof the sounds that only come with experience are useful for thepercussive technique to be successful.

A human factor of auditory distinction is a quality factor of thetechnique. The variation in applied impulse strength (tapping of thefinger), duration of the impulse (tapping of the finger), variations inthe fingers of healthcare professionals, hearing acuity of healthcareprofessionals, and more make standardization of percussive methods andresults difficult, resulting in ambiguity. While training and experiencecan mitigate these effects, there is also an inherent healthcareprofessional distraction leading up to the interpretation phase of thepercussion. For example, the healthcare professional concentrates oneffecting the percussive impulse, then quickly (e.g., less than amillisecond after) switches concentration to listening to the soundwhich emanates from the subject's body due to the percussive impulse.This may be difficult for some healthcare professionals.

Further, when practicing indirect percussion, both of the healthcareprofessional's hands are occupied, leaving it impossible to hold astethoscope or other tool if desired. (Direct percussive technique mayonly involve the tapping finger directly onto the surface of a subject,rather than tapping an intermediate finger between the tapping fingerand the surface of the subject.) A healthcare professional may alsopercuss various areas on the body introducing further variability basedon how hard the percussive impulse is, etc. In addition, a healthcareprofessional may repeat the percussive method in the same place becauseof uncertainty when interpreting results and variability in applying thepercussive force.

Accordingly, described herein is a device, method, and computer readablemedia for implementing a percussive method to enhance the repeatabilityof delivering a percussive impulse and to aid in interpreting theresults by reducing uncertainty and variability.

FIG. 9 is a schematic diagram of a percussive device 900 according tosome embodiments of the disclosure. The percussive device 900 provides apercussive force to a subject using a percussive element 912. Thepercussive element 912 may be used to apply a direct or an indirectpercussive force, depending on how the percussive element 912 isconfigured. An example of a percussive element for providing an indirectpercussive force is described below with respect to FIG. 10.

The percussive device may further include an I/O interface 904, anexternal interface 910, a power supply 908, a processor 906, a switch914, a memory 918, and an acoustic sensor 916. Although shown in asingle housing as the percussive device 902, these components may be inseparate housings, separable from one another, moveable independent ofone another, and/or may be part of another electronic module/accessory.For example, the percussive device 902 may not have its own power supply908, and instead is supplied by power through the external interface 910(e.g., through a daisy chained powered I/O as described herein). Inanother example, the percussive element 912 and/or the acoustic sensor916 may be movable separate to the rest of the percussive device 902,such that different areas of the body may easily have a percussive forceapplied or be checked for a response to the percussive force. In variousembodiments, rather than having its own acoustic sensor 916, amicrophone of another module (e.g., of the electronic stethoscope mainunits 204 of FIG. 2 or 304 of FIG. 3) may be used as the acoustic sensorto measure a response of the subject to a percussive force.

The switch 914 may be used to turn on and off the percussive device 902.In various embodiments, the switch 914 (or a different switch) may beused to cause the percussive device 902 to deliver the percussive forcewith the percussive element 912. The processor 906 may be used tocontrol the percussive element 912, analyze signals from the acousticsensor 916, send information (e.g., signal information received from theacoustic sensor 916) to another computing device through the externalinterface 910, or for any other function or method as described herein.The memory 918 may have stored thereon non-transitory computer readableinstructions that may be executed by the processor 916 to perform any ofthe functions or methods described herein.

In various embodiments, the percussive device 902 may be removablyattachable to a stethoscope. In various embodiments, the percussivedevice 902 may also be incorporated/integrated into a stethoscopepermanently. Whether removably attached to, permanently integrated into,or being used as a standalone device, the percussive device 902 may beadvantageously held in and operated using one hand by a healthcareprofessional. In various embodiments, the percussive device 902 oraspects of the percussive device 902 may be removably attached to aliving subject. For example, if the acoustic sensor 916 is outside amain housing of the percussive device 902, the percussive device 902 maybe held by one hand while the acoustic sensor 916 is stuck usingadhesive to a different location on the living subject. In variousembodiments, the percussive device 902, the percussive element 912, etc.may also be adhered to the living subject. The percussive device 902 mayalso be used as a module in conjunction with other modules/accessoriesdescribed herein (regardless of whether the percussive device 902 isused with a stethoscope). As just some examples, a battery module may beused to power the percussive device, microphone and/or signal processingmodules may be used in conjunction with the percussive device 902 topick up and process the acoustic response of the subject to thepercussive force, etc.

In various embodiments, having an extra free hand may allow a healthcareprovider to hold the drum/bell end of a stethoscope to listen withstethoscope with their free hand. In such an embodiment, the acousticsensor (e.g., microphone) of an electronic stethoscope may be used inaddition to or instead of the acoustic sensor 916 to detect a subject'sresponse to the percussive force. Where the percussive device 902 isadhered to or otherwise attached to the subject, the use of the devicemay be hands free for the healthcare professional.

Advantageously, an electronic application of a percussive force allows ahealthcare professional to focus on the output of the subject (e.g.,their response to the percussive force) rather than applying thepercussive force. The embodiments described herein also advantageouslyapply more predictable and certain percussive forces, leading to moremeaningful outputs/responses. In addition, the embodiments hereinprovide for applying a percussive force that has qualities that areconsistent, metered (measurable and quantifiable), and repeatable. Theembodiments herein also provide for a healthcare professional to adjustthe percussive force as desired, and the amount or magnitude of thatforce may be indicated via a metered force dial that the healthcareprofessional may adjust and/or some sort of analog or digital displayfeedback to indicate the magnitude of the percussive force beingapplied.

Further, the sound of a response of a subject to a percussive impulsemay also be recorded by the percussive device 902 and stored in thememory 918 (or may be recorded/stored by a device the percussive device902 is in communication with). This may provide benefits such astransmitting the response to other devices, including for example remotehealthcare providers. The responses may also be used for teaching, andmay be stored as part of a health record to be referred to later. Forexample, a healthcare professional may wish to listen to a subject'shistorical response to a percussive impulse in addition to listening totheir current response to a similar percussive impulse to gauge forchanges in the density/makeup of a particular portion of the subject. Inanother example, a healthcare professional may also replay the resultsthat have just been recorded to gain clarity on what was heard. This mayall advantageously further improve the accuracy and meaningfulness ofthe percussive technique.

Audio processing may also be performed on a captured response to slowdown a captured audio waveform. In various embodiments, processing thatpreserves pitch/frequency may also be used. Such processing may help theobserver's audio senses have extended time to interpret the audioresponse of the subject to the percussive impulse. A captured waveformmay also be displayed on an x/y graph wave form display or any othertype of display. This may allow an observer to see responses/echoesvisually. The location of where the percussive force is applied and/orthe location of the listening/sensing device may be changed/adjusted toenhance resolution and/or meaning of the results of the percussivemethod as described herein.

Various other processing may also be advantageously performed on thecaptured audio signal. For example, processing may be done toautomatically identify echoes and determine metrics such as time and orintensity characteristics of those echoes.

An impulse (such as that applied by the percussive device 902) may betheoretically characterized as an imaginary signal with all frequencies.If such an impulse is fed into a filter, then theaspects/characteristics of that filter may be characterized by readingthe impulse response. Similarly, the percussive impulse is theintroduction of many frequencies into the body of a subject as energy.The sound of the response to that impulse may similarly characterizeaspects of the subject. In other words, the returning sound may includeintensity fronts, indicating characteristics of what is inside thesubject.

With such a concept in mind, an enhanced percussive device may havemultiple acoustic sensors that may be placed at different locations onthe subject's body. In other words, a percussive device may deliver apercussive force at a single location and have a number N listeningdevices at locations around the body. The response waveform sensed ateach acoustic sensor is digitized. The time correlation may be syncedamong them, and the relative positions of each acoustic sensor on thebody may be noted and preserved (and associated electronically with thewaveforms captured). With this information, a three-dimensional (3D) mapof the acoustic density of the body may be created. The granularity andresolution of the 3D map may be a function of the number N and anyprocessing that is done to those waveforms. This offers manyimprovements and advantages over traditional percussive techniqueinterpretation.

FIG. 10 is a schematic diagram of a percussive element 1000 of apercussive device according to some embodiments of the disclosure. Thepercussive element 100 includes a linear actuator 1002. The linearactuator 1002 is configured to move a plunger 1004 linearly in responseto application or removal of an electrical signal. The percussiveelement 1000 also includes a membrane 1006 having a first surface and asecond surface. The first surface is opposite the second surface. Thelinear actuator 1002 moves the plunger 1004 in response to an electricalsignal such that the plunger 1004 impacts the first surface of themembrane, providing an indirect percussive force through the membrane1006 to a surface of a subject on the second surface of the membrane1006. The membrane 1006 is configured to transmit that percussive forcefrom the first surface to the second surface as a result of the plunger1004 impacting the first surface of the membrane 1006. In variousembodiments, the percussive device 1000 may not have the membrane 1006,and therefore may apply a direct percussive force to a subject. Invarious embodiments, the plunger may also have a coating, such as acoating with a similar acoustic density to human skin and/or fat tissue(or some combination thereof), or any other type of specialized coating.In other embodiments, the plunger may not have a particular coating.

In various embodiments, the linear actuator 1002 is an electromechanicalsolenoid. In various embodiments, any other type of inertial elementthat is electromotive driven to provide an impact force may be usedinstead of a linear actuator. For example, a voice coil may also beused. Voice coils may be highly controllable, allowing for consistentand dependable impact. In various embodiments, a release of storedenergy may also be used to apply a percussive force. For example, energymay be stored in a spring that is compressed, and that energy may bereleased via mechanical and/or electromechanical components as desiredby the user and/or the control circuitry of the electronic stethoscope.Accordingly, various types of electromechanical or electro-magneticsolenoids may be used as the linear actuator 1002.

The percussive element 1000 may also include a housing designed to beheld in one hand or to be strapped or otherwise adhered to the patient,or may be combined into a housing of the percussive device 902 asdescribed herein. Accordingly, the percussive element 1000 mimics thefinger tapping percussion technique for detecting tissue density basedon sound.

The plunger 1004 and/or the membrane 1006 may be made of materials ofsimilar acoustic density to human bone to more closely simulate manualpercussive technique. In other words, the membrane and/or the plunger1004 may have an acoustic density within the range of the averageacoustic density of human bone. For example, an elastomer with anacoustic density similar to human skin and/or fat tissue (or somecombination thereof) may be used, which is put in contact with thesubject's skin to provide an interface for the percussive device withthe subject. In another example, the membrane 1006 may be made of a hardplastic with a rubber coating or layer on the outside to approximate afinger with a rigid inside and a softer outside. The plunger 1004 mayalso be rigid with a rubber coating or layer to again approximate afinger. As described herein, the percussive element 1000 may apply apercussive force at a consistent, repeatable power and interval. Thepercussive element 1000 may also apply variable levels of percussiveforce and/or percussive momentum. The percussive element 1000 may bemounted on a stethoscope, such as on a head of a stethoscope. Thepercussive element 1000 may also be a separate device from astethoscope. A stethoscope, such as those described herein whetheracoustic or electronic, may be used to detect a signal that passesthrough the body of a subject as a result of a percussive force appliedby the percussive element 1000. If an electronic stethoscope is used,various signal processing techniques may be utilized to recognizepatterns or characteristics of the signal detected. For example, thesignal processing may determine if the signal has passed through liquid,gas, bone, etc., such that an electronic stethoscope may be used toautomatically determine and notify a user of a change or abnormality

FIG. 11 is a flow diagram illustrating a method 1100 for using apercussive device according to some embodiments of the disclosure. Themethod 1100 may be implemented using a percussive device as describedherein, such as the percussive device 902 of FIG. 9.

At operation 1102, an apparatus for applying a percussive force ispositioned at a first location of a living subject. At an operation1104, an acoustic sensor is positioned at a second location of theliving subject. Operations 1102 and 1104 may be distinct if theapparatus for applying a percussive force and the acoustic sensor aremovable separate from one another. In various embodiments where theapparatus for applying the percussive force and the acoustic sensor arenot movable separate from one another, the operations 1102 and 1104 maybe performed simultaneously.

At an operation 1106, a first electrical signal is applied to a linearactuator causing a plunger to move linearly such that it impacts a firstsurface of a membrane. As described herein, the membrane may include asecond surface opposite the first surface, and the membrane transmits apercussive force from the first surface to the second surface and intothe living subject as a result of the plunger impacting the firstsurface of the membrane. As also described herein, the first electricalsignal may be controlled to cause a desired magnitude, length, momentum,etc. of the percussive force delivered by the linear actuator.

At an operation 1108, a second electrical signal indicative of aresponse of the living subject to the plunger impacting the membrane andtransmitting the percussive force into the living subject is generatedby the acoustic sensor. A signal captured by the acoustic sensor may betranslated into data indicative of the second electrical signal. Thatdata may be saved to a memory of a computing device. That saved data maybe used to play the second electrical signal through a speaker at a timeafter the second electrical signal was generated. A visualizationindicative of the second electrical signal may also be displayed on adisplay of a computing device as described herein.

That visualization of the second electrical signal may be considered afirst visualization. Subsequent percussive method tests may be performedon the same subject at the same or different locations on the body atthe same or at different times, or may be performed on differentsubjects at the same or different locations on the body at the same orat different times. Visualizations from those percussive instances maybe compared to the first visualization on a display.

Similarly, other acoustic sensors may be placed on the subject tocapture data on responses of the same subject in different locations tothe same percussive force. Those responses may also be visualized andcompared to other responses. All of these visualizations and data may befurther analyzed to study for patterns with respect to an individual, apopulation or demographic, over time, etc.

Other various signal processing techniques may be used in conjunctionwith the detected signals described herein. For example, signals may bedetected and processed when using a percussive element as describedherein to shift inaudible frequencies into frequencies that are audibleto humans. In this way, insights may be achieved that were previouslynot possible using a percussive technique. Various processing to providesignal equalization may also be used. For example, processing may makehigher frequencies a higher volume (e.g., increase amplitude) and lowerfrequency lower volume (e.g., decrease amplitude) so a user can hear awide band of frequencies appropriately without losing information. Inaddition, certain frequencies could be isolated so that a user onlyhears certain frequencies that may be indicative of certain information,or may be easier to interpret if other frequencies are filtered out.Users may also customize the frequencies they would like to hear or thevolume the prefer for different frequencies into different predeterminedaudio settings.

The various systems and methods described herein may also use algorithmsto study data from signals captured to look for patterns over time inthe data/signals. For example, machine learning may be used to train amodel/algorithm for recognizing patterns in data/signals. For example,once a model/algorithm is trained to identify patterns or indicators ofcertain health problems, conditions, or risk factors, signals capturedat different times of the same patient may be fed into the algorithm todetect changes or indicators of particular issues.

The various systems and methods described herein may also providetelemedicine uses and applications. For example, in real time,data/signals captured may be visualized for a telemedicine healthprovider remotely. A telemedicine health provider may also be able toremotely hear audio signals captured and processed. Analysis of thedata/signals may also be automated in real time, which may be viewedand/or interpreted by the telemedicine provider. The repeatability offorce possible using the percussive device provided herein providesuseful input data to get reliable and helpful output audio/signals froma patient. Accordingly, the output signals/data related to multiple timecorrelated percussions may be blended, compared, etc. in ways that wouldnot be reliable using a hand/finger percussive method because the inputpercussive force could not be replicated and controlled. Therepeatability also provides the ability to apply the same amount offorce in slightly different locations on a patient, further enhancingthe usefulness of data/signals detected from one or more locations on apatient.

Signal processing may also include windowing a detected percussiveresponse. For example, a percussive device as described herein may beused to introduce energy into a person's body for the purpose ofdiagnosing what is inside the body. One problem with using a traditionalacoustic stethoscope with the percussive method is that a large initialsound, which is directly caused by the percussion, is loud compared withthe diagnostic portion which comes in a short amount of time, directlyafter the initial, direct percussive response. Human physiology is suchthat the initial direct response may be very loud and/or unpleasant to alistener if the following, fainter sound response is to be heard. Inother words, because the fainter response is so close in time to theinitial direct response, there is little to no time to manually adjust avolume perceived by the user by, for example, keeping an acousticstethoscope away from the subject during the louder direct response andthen moving the stethoscope into contact with the subject for thefainter, diagnostically important response. In addition, a loud sound,even if unpleasant, followed by a faint sound may cause the perceptionof the faint sound to be diminished.

However, using an electronic stethoscope and signal processing mayalleviate or solve these issues. For example, the amplitude of thefainter sound may be increased following the initial percussive event,which will aid in perception of the healthcare provider. Signalprocessing may be used to correlating a time windowed attenuation orelimination of the initial direct percussion sound. That is, the initiallouder sound may be identified and have its amplitude reduced or eventeliminated so that it is not heard by the user. The more importantauditory data may then be concentrated on by a user without perceptiondistraction caused by the louder signal. The fainter, diagnosticallyimportant signal may also have its frequency shifted to a spectrum ofhearing which most people have better auditory recognition (e.g., thefrequency band in which human speech occurs). The isolateddiagnostically important signal may also be slowed down (e.g., stretchedin time) while keeping the frequency content intact with the option toalso shift the frequency as mentioned herein to a range better suitedfor a human listener.

Sampling, recording, and/or visualization of the faint response may alsobe performed. The sampling, recording, and/or visualization may be donebefore or after various aspects of signal processing described herein.In this way, a raw signal and/or a processed signal may be saved. Wherea raw signal is saved, this may be valuable as various signal processingmay be applied to the raw signal later in time to determine differentinformation, test the efficacy of different signal filtering, etc.Accordingly, various filtering, replay (e.g., one percussion performedbut many chances to listen), frequency equalization, etc. may all beutilized. Visualization of a signal, such as graphing the faint waveformon a phone or other display with time or distance estimation markers mayalso be used to show, for example, impulse response echoes. Athresholding algorithm may also be used to determine known or sampledheuristics to guide clinician to a diagnostic conclusion based on thecaptured signal. Remote diagnostics of the contents of internal cavitiesmay also be performed using a saved signal. Patient administeredpercussion may also be possible, and the signal may be interpretedremotely or at a later time, by a healthcare provider and/or with anautomated process. Data/signal responses to multiple time correlatedpercussions may also be blended to get an average response, compared todetermine changes over time, etc. Blended signals may also provide datawith reduced signal to noise ratio or other errors.

The various percussive methods described herein may also be used onother bodies than human bodies. For example, the device may be used onrocks to determine if they are hollow, such as with certain types ofgeodes.

FIG. 12 is a schematic diagram of a laser detection device 1200 formeasuring vibrations of a surface of a living subject 1206 according tosome embodiments of the disclosure. The laser detection device 1200includes a laser emitter 1204, which emits a first laser beam 1212 and asecond laser beam 1216. The first laser beam 1212 reflects off of theliving subject 1206 at a point 1210. The first laser beam 1212 interactswith the living subject 1206 at the point 1210, and at least some of thelight from the first laser beam 1212 reflects off of the living subject1206 as a first reflected laser beam 1214. Although the firstreturn/reflected laser beam 1214 includes some of the same light as thefirst laser beam 1212, it is not all of the light from the first laserbeam 1212 and the light of the first reflected laser beam 1214 may havedifferent characteristics of the first laser beam 1212. Accordingly, forclarity, the emitted laser beam from the emitter 1204 and the beam thatresults from reflection off the living subject 1206 are referred toherein as separate beams: the first laser beam 1212 and the firstreflected laser beam 1214. Similarly, the emitter 1204 also emits asecond laser beam 1216 that reflects off the living subject 1206 at apoint 1208, resulting in second reflected laser beam 1218. In analternative embodiment, the laser emitter 1204 only emits a single laserat a time, and the beams 1212 and 1216 shown in FIG. 12 are emitted atdifferent times to reflect off of two different locations of the living.In any embodiment, the practical effect is the same, that vibrations atmultiple points on the surface of a living subject may be detected,whether at the same time or at different points in time. In particular,changes in amplitude from an emitted beam after it has been reflectedare measured to detect vibrations on the surface of the living subject.

The first reflected laser beam 1214 and the second reflected laser beam1218 may be detected by a detector 1202. Changes in the beams 1214 and1218 detected by the detector may be used in conjunction with what isknown about the emitted beams 1212 and 1216 to determine aspects of thesurface of the living subject 1206 at the points 1208 and 1210, such asvibrations. Vibrations may be indicative of breathing, blood flow, etc.Such methods and systems may be valuable for checking vitals such asbreathing and pulse from long range. The output from the detector couldalso be processed and sent to a speaker or headphones so that someonecan hear the vibrations of the living subject from afar.

This enhanced system for detecting vibrations of the surface of a livingsubject has several advantages. The acoustic stethoscope is large andheavy, relative to the embodiments of a laser detection device describedherein. The acoustic stethoscope also uses intimate surface contact withthe skin of a subject, which may be avoided using the laser detectiondevice. Further, movement of the stethoscope on the surface creates anoise which corrupts a received signal. Advantageously, this does notoccur with the laser detection device described herein.

The laser beams 1212 and 1216 emitted by the emitter 1204 may havesimilar or different characteristics. For example, the characteristicsmay be varied based on what is being measured and/or a location of thebody the beams are pointed at. The varied characteristics may befrequency, phase, amplitude, color, whether the laser is visible tohumans or not, or any other aspect.

The laser beam(s) may be pointed to a location on the body where ahealthcare professional or other operator knows there is a goodpotential to pick up vascular surface vibrations or the sounds createdwhen a person breathes. Surface vibration cause the reflected laser beamto vibrate in terms of the reflection intensity at a given direction.These surface vibrations are representative of the sounds from insidethe body.

The laser frequency (wavelength) of the emitted beams may, in variousembodiments, be visible or invisible (e.g., infrared, ultraviolet). Avisible spot laser may also be added to accompany an invisible laser.This is to allow an operator to know where the laser emitter is pointed,i.e. where the invisible laser spot is on the body. This may include away to switch off the visible laser after the location the invisiblelaser is pointed at is known. In other words, a visible laser beam isused to illuminate a point of the surface of the living subject at whichan invisible laser beam is directed.

The laser beam direction and receiver direction are such that the opticsof the receiver are looking in the direction of the laser point emittedby the emitter. However, the field of view of the receiver and the sizeof the laser beam spot may be expanded or configured as desired.

In various embodiments, emitted beams may be modulated to a highfrequency, such as 500 kilohertz (KHz), 1 megahertz (MHz), 10 MHz, oranother frequency. The modulation is such that the laser light intensityhas a frequency component of a known value or inside a known frequencyrange. Other frequency harmonics and direct current (DC) may exist inthe modulated laser energy spectrum, but may be removed from a detectedbeam so that the actual vibrations of the surface of the living subjectmay be determined. For example, an emitted beam is modulated to a highfrequency and aimed toward a living subject. The beam then reflects offthe living subject and is picked up by a detector. That detectedreflected beam is then demodulated to remove the carrier frequency andisolate the aspects of the reflected beam related to the vibrations ofthe surface of the living subject. In order to demodulate the reflectedbeam, a detector may include components to detect both an optical fieldof view and laser light frequencies. For example, the detector mayinclude one or more laser light frequency filters. In this way, thedetector can use the optical field of view and laser light frequencydetection components to discriminate between and isolate the surfacemodulated signal (the reflected laser beam) from any unwanted signals(e.g., ambient light in the room, movement of patient, etc.). In justone example, the detector may be focused and/or zoomed in on thelocation of the reflected laser beam, and a notch color/infrared (IR)pass filter preceding the detector to help isolate the light of interest(the reflected laser beam).

The detector receives the high frequency modulated laser light, whosereceived energy intensity has been further modulated by the movement ofthe surface of the body. The vibration information of the body surfaceis present in the high frequency as a superimposed image of the surfacevibration in the frequency domain, centered around the high frequencysignal. Demodulation techniques may be used to extract the surfacevibrations from the high frequency signal. For example, amplitudemodulation (AM) may be used to modulate and demodulate beams/signals. Invarious embodiments, a standard AM receiver may be used to demodulatethe skin surface vibration information contained in the high frequencyreceived signal and convert them to a base band signal. The base bandsignal may be listened to in real time by an operator and/orrecorded/stored. Such modulation reduces ambient noise and ambient lightinterference. In addition, the unintended movement of the laser beamover the skin may otherwise create distortion in the signal.

The target location of the laser beam spot may be moved by severalmeans. The purpose is to allow for listening and mapping of thevibrations related to the heart and or vascular vibrations. The mappingmay be a simple manual mode where the operator manually changes the spotposition and observes and or records the resulting vibrations.

In an enhanced device, the manual movement may be tracked by the meansof inertial, rotational and gyroscopic sensors present in the device.This provides a correlation between the set of vibration measurementsand the relative position on the subject's body. A further enhancementis the means of providing a start point input means. The start point maybe any pre-defined point on the body and requires operator to provide aninput to the system that the laser spot is on a particular point of thebody. Other body metrics can be used such as shirt size, height, weight,body width to further enhance the positional knowledge of the system.

An automated scanning method may also be implemented with a laserdetection device (e.g., the laser detection device 1200 of FIG. 12).Such a scanning method, through mechanically controlled motion of theemitted laser beam(s), including position and rotation of the laseremitter (and detector accordingly) may scan sections of the body,correlating the vibrations detected to the position of the body of thebody currently being scanned. The operator or system may either startthe scan at a predefined position or record the start position.Similarly, the end of the scan may be predefined or manually implementedby an operator. Information about a subject's body may also be notedusing an automated process, so that the region of the body scanned isnoted, and the system may determine a starting or ending position basedon information about a particular body. This may be done to betterdefine body position of the variable position laser spot and noteexactly the part of each body scanned.

In various embodiments, mirrors may be rotated in front of the laserbeam and detector optical path for the purpose of moving the laser spotand correlation of the location monitored and or recorded on the body.In this way, instead of mechanically moving the detector and/or emitter,only the mirrors are moved.

Various embodiments may have a fixed, omnidirectional detector. Suchembodiments may have several advantages. For example, the receiver maynot use as much battery power (e.g., the field of view of thereceiver/detector does not need to be as large). In such embodiments,battery power may be used on more processing and amplification of theemitted and detected signals.

Various embodiments may also have recording, wide area network (WAN)connection capabilities through which the devices may communicateinformation captured and/or be controlled. Storage/memory and/or othersignal processing and communication aspects may also be implemented.

As described herein, various modules may be used for an operator or someother person to listen to the surface vibration detected by a laserdetection device. Such vibrations may have been converted to an audiosignal via speaker, headphone, communicated via wireless to a phone,wireless speaker, remote listening device, etc. In other words, thelaser detection device may be used in conjunction with othermodules/accessories described herein, such as the speaker and/orheadphone modules described above with respect to FIGS. 2 and 3. Othermodules may also be used with a laser detection device, such as abattery module, signal processing module, etc. Although the laserdetection device may be used instead of a stethoscope, the laserdetection device may still be attachable to a stethoscope or may be usedindependent of a stethoscope. In various embodiments, the laserdetection device may be substitute for the stethoscope in any of theembodiments described herein, such that any of the modules/accessoriesdescribed herein may interact with and/or be used with the laserdetection device. In such examples, the laser detection device outputs asignal that may be used, processed, visualized, etc. similar to a signalpicked up by a microphone or other sensor of electronic stethoscope orelectronic stethoscope module as described herein. Prior to or aftertransmission or conversion of such a signal, the signal from the surfaceof the skin, which represents faithfully the movement at a small spotarea, may be enhanced by one or more signal processing components and/ormodules. One such enhancement could be to filter the true signal suchthat it sounds like the false or distorted signal clinicians arefamiliar hearing from the common stethoscope due to noise. Otheradjustments and processing such as amplitude adjustments and others aredescribed herein.

The signal captured by a laser detection device may also be digitized.This digital form may have many advantages. The digitized skinvibrations may be accompanied by/stored with position information ofwhere on the body the vibration data was collected. A matrix or a myriadof data may be captured and created. The data may be listened toremotely by transmitting the data, then converting the base bandvibration data to sound as described herein. Such uses may be valuablein telemedicine.

In addition, the digital data may be amplified, waveform shaped,enhanced, filtered, etc. using audio processing techniques. For example,digital signal processing algorithms for noise reduction, equalizing,amplification, automatic gain control, and any other processing may beused. Such processing may be performed locally in the laser detectiondevice, on a separate hand-held device, in the cloud, on anothercomputing device, and/or raw data may be stored for later review andprocessing.

The separate locations scanned may be combined and looked at (visualizedon a display) or listened to as a set. Accordingly, individual data setstaken at different locations may be synchronized and/or combined. Thismay also advantageously remove time variations and other disparateartifacts. Various embodiments may also have two or more detectiondevices operating simultaneously. This provides for capturing of data atthe same time of two locations (e.g., at two locations in a blood flowpath).

FIG. 13 is a flow diagram illustrating a method 1300 for measuringvibrations of a surface of a living subject according to someembodiments of the disclosure. At an operation 1302, a first laser beamis emitted and directed at the surface of the living subject. The firstlaser beam is configured to interact with the surface of the livingsubject such that a reflected laser beam reflects from the surface ofthe living subject. The reflected laser beam has differentcharacteristics from the first laser beam at least in part due to theinteraction with the surface of the living subject and the vibrations ofthat surface.

At an operation 1304, the reflected laser beam that is reflected fromthe surface of the living subject is detected. At an operation 1306, thedetected reflected laser beam is processed to determine vibrations ofthe surface of the living subject. The output after processing may be asignal that may be output as audio and approximates a sound of thevibrations of the surface of the living subject that would be detectedif a stethoscope was used to detect the vibrations. The processing mayalso filter out ambient noise and light interference. The system mayalso output, after the processing, a visualization indicative of thevibrations to a display of a computing device.

Various signal processing may also be used along with the remotesensor/laser device and methods described in FIGS. 12 and 13. Forexample, amplitude or frequency modulation of the output signal of thedevice may be used, so that when a response signal is detected, theresponse signal may be demodulated to determine the data of interest.This may assist in accurately determining data embedded in a signal andprotect the data against corruption from noise, a weak signal, etc.,providing higher sensitivity and accuracy of the device.

In various embodiments, microwave signals (e.g., a 24 GHz radar) may beused to detect movement of a subject to monitor, for example, breathingand/or heart rate. Such a device may be incorporated into a modularstethoscope as described herein. An accelerometer may also beincorporated into a modular stethoscope or otherwise be worn by asubject, so that if the subject (e.g., heart, chest, etc. of a subject)moves that movement may be accounted for.

Other devices may also be incorporated into a modular stethoscope asdescribed herein. For example, an SPO₂ sensor or an electrocardiogram(EKG or ECG) device may also be incorporated into a modular stethoscopeas either removable or permanent components.

Various embodiments are further described in the numbered clauses below:

-   Clause 1. An electronic stethoscope apparatus comprising:    -   a microphone configured to generate an electrical signal in        response to received sound from a living subject;    -   amplification circuitry operably coupled to the microphone and        configured to amplify the electric signal generated by the        microphone;    -   a speaker operably coupled to the amplification circuitry and        configured to output the electric signal after amplification;        and    -   a power supply configured to power the amplification circuitry.-   Clause 2. The electronic stethoscope apparatus of clause 1, wherein    the microphone is embedded into tubing connected between a diaphragm    and an ear piece, wherein the tubing is configured to allow acoustic    sound waves to travel from the diaphragm to the ear piece, and    wherein the microphone does not impede the acoustic sound waves from    traveling within the tubing.-   Clause 3. The electronic stethoscope apparatus of clause 1, further    comprising a power output port operably coupled to the power supply    and configured to provide power from the power supply to a modular    electronic device configured to removably connect to the power    output port.-   Clause 4. The electronic stethoscope apparatus of clause 1, further    comprising a processor configured to determine whether the    electronic stethoscope is in use, and wherein the processor is    further configured to:    -   cause power to be provided to the amplification circuitry while        the electronic stethoscope is in use; and    -   cause power to not be provided to the amplification circuitry        while the electronic stethoscope is not in use.-   Clause 5. The electronic stethoscope apparatus of clause 4, wherein    the determination that the electronic stethoscope is not in use is    made based on whether a headphone is plugged into a headphone port    on the electronic stethoscope.-   Clause 6. The electronic stethoscope apparatus of clause 4, wherein    the determination that the electronic stethoscope is not in use is    made based on whether a wireless headphone is wirelessly connected    to the electronic stethoscope.-   Clause 7. The electronic stethoscope apparatus of clause 4, wherein    the determination that the electronic stethoscope is not in use is    made based on an amplitude of the electrical signal generated by the    microphone is below a predetermined threshold.-   Clause 8. The electronic stethoscope apparatus of clause 4, further    comprising a motion sensor, and further wherein the determination    that the electronic stethoscope is not in use is made based on an    output of the motion sensor.-   Clause 9. The electronic stethoscope apparatus of clause 8, wherein    the output of the motion sensor indicates that the electronic    stethoscope has not been moved for at least a predetermined    threshold of time.-   Clause 10. A light apparatus comprising:    -   a light;    -   a switch to turn the light on or off; and    -   a clipping mechanism configured to attach the light apparatus to        a bell portion of a stethoscope, wherein the switch is        accessible while the light apparatus is attached to the bell        portion.-   Clause 11. The light apparatus of clause 10, wherein the clipping    mechanism comprises flexible, rubberized plastic configured to    deflect when attaching the light apparatus to the stethoscope or    detaching the light apparatus from the stethoscope.-   Clause 12. The light apparatus of clause 11, wherein the flexible,    rubberized plastic is configured to dampen noise from passing from    the light apparatus into the stethoscope.-   Clause 13. The light apparatus of clause 10, wherein the clipping    mechanism is configured to fit on at least two different sized bells    of at least two different stethoscopes.-   Clause 14. The light apparatus of clause 10, wherein the light    apparatus is configured not to block any portion of a diaphragm of    the stethoscope when the light apparatus is attached to the bell    portion of the stethoscope.-   Clause 15. The light apparatus of clause 10, wherein the clipping    mechanism comprises at least two arms configured to wrap around the    outer perimeter of the bell portion.-   Clause 16. The light apparatus of clause 15, wherein at least one    arm of the at least two arms is operably connected to a spring, such    that the at least one arm is movable when attaching the light    apparatus to the bell portion and the spring holds the at least one    arm in place after the light apparatus is attached to the bell    portion.-   Clause 17. The light apparatus of clause 10, wherein the light is    powerable by a battery and the battery is at least one of:    -   stored directly in the light apparatus; or    -   stored in a different portion of the stethoscope than the light        apparatus and wherein the light apparatus is electrically        connected to the different portion through an electrical wire.-   Clause 18. The light apparatus of clause 17, wherein the battery is    stored in the different portion of the stethoscope, and the    electrical wire is removably connected to the light apparatus.-   Clause 19. The light apparatus of clause 17, wherein the battery is    stored directly in the light apparatus, and the light apparatus    further comprises a port for removably connecting a device to the    light apparatus, such that the device is powered by the battery.-   Clause 20. The light apparatus of clause 17, wherein the battery is    stored directly in the light apparatus and the battery is configured    to be at least one of:    -   removable from the light apparatus such that the battery is        changeable when the battery dies;    -   non-removable from the light apparatus; or    -   rechargeable.-   Clause 21. An apparatus for applying a percussive force to a living    subject, the apparatus comprising:    -   a membrane having a first surface and a second surface, wherein        the first surface is opposite the second surface; and    -   a linear actuator configured to move a plunger linearly in        response to application or removal of an electrical signal,        wherein:        -   the linear actuator is configured to move the plunger such            that the plunger impacts the first surface of the membrane;            and        -   the membrane is configured to transmit a percussive force            from the first surface to the second surface as a result of            the plunger impacting the first surface of the membrane.-   Clause 22. The apparatus of clause 21, wherein the linear actuator    comprises an electromechanical solenoid or a voice coil.-   Clause 23. The apparatus of clause 21, wherein the linear actuator    is actuated by an energy storage device.-   Clause 24. The apparatus of clause 21, wherein the apparatus is    configured to be removably attachable to a stethoscope.-   Clause 25. The apparatus of clause 21, wherein the apparatus is    incorporated into a stethoscope.-   Clause 26. The apparatus of clause 21, wherein the membrane has an    acoustic density within the range of the average acoustic density of    human bone.-   Clause 27. The apparatus of clause 21, wherein the apparatus is    configured to be held in one hand.-   Clause 28. The apparatus of clause 21, wherein the apparatus is    configured to be removably attached to the living subject.-   Clause 29. A method comprising:    -   positioning an apparatus for applying a percussive force at a        first location of a living subject;    -   positioning an acoustic sensor at a second location of the        living subject;    -   applying a first electrical signal to a linear actuator causing        a plunger to move linearly such that it impacts a first surface        of a membrane, wherein:        -   the membrane comprises a second surface opposite the first            surface, and        -   the membrane transmits a percussive force from the first            surface to the second surface and into the living subject as            a result of the plunger impacting the first surface of the            membrane; and generating, by the acoustic sensor, a second            electrical signal indicative of a response of the living            subject to the plunger impacting the membrane and            transmitting the percussive force into the living subject.-   Clause 30. The method of clause 29, wherein the first electrical    signal is controlled to cause a desired magnitude of the percussive    force.-   Clause 31. The method of clause 29, wherein the first electrical    signal is controlled to cause a desired length of the percussive    force.-   Clause 32. The method of clause 29, wherein the membrane has an    acoustic density within the range of the average acoustic density of    human bone.-   Clause 33. The method of clause 29, wherein the linear actuator    comprises an electromechanical solenoid or a voice coil.-   Clause 34. The method of clause 29, wherein data indicative of the    second electrical signal is saved to a memory of a computing device.-   Clause 35. The method of clause 34, further comprising playing the    second electrical signal through a speaker using the saved data at a    time after the second electrical signal was generated.-   Clause 36. The method of clause 29, wherein a visualization    indicative of the second electrical signal is displayed on a display    of a computing device.-   Clause 37. The method of clause 36, wherein the visualization of the    second electrical signal is a first visualization, the response of    the living subject to the plunger impacting the membrane and    transmitting the percussive force into the living subject is a first    response, and further wherein:    -   the second electrical signal was captured at a first time;    -   a second visualization is displayed on the display along with        the first visualization;    -   the second visualization is indicative of a third electrical        signal;    -   the third electrical signal is indicative of a second response        of the living subject to the plunger impacting the membrane and        transmitting the percussive force into the living subject; and    -   the third electrical signal is captured at a second time        different from the first time.-   Clause 38. The method of clause 29, wherein the acoustic sensor is a    first acoustic sensor, and further comprising:    -   positioning a second acoustic sensor at a third location of the        living subject, the third location being different than the        second location; and    -   generating, by the second acoustic sensor, a third electrical        signal indicative of the response of the living subject to the        plunger impacting the membrane and transmitting the percussive        force into the living subject.-   Clause 39. An apparatus for measuring vibrations of a surface of a    living subject, the apparatus comprising:    -   an emitter configured to emit a laser beam directed at the        surface of the living subject, wherein the laser beam is        configured to interact with the surface of the living subject        such that a reflected laser beam reflects from the surface of        the living subject, and further wherein the reflected laser beam        has different characteristics from the laser beam at least in        part due to the interaction with the surface of the living        subject;    -   a detector configured to detect the reflected laser beam that is        reflected from the surface of the living subject; and    -   a processor configured to process the detected reflected laser        beam to determine vibrations of the surface of the living        subject.-   Clause 40. The apparatus of clause 39, wherein the emitter is a    first emitter, the laser beam is a first laser beam, and the    apparatus further comprises a second emitter configured to emit a    second laser beam directed at the surface of the living subject.-   Clause 41. The apparatus of clause 40, wherein the second laser beam    has different characteristics than the first laser beam.-   Clause 42. The apparatus of clause 40, wherein the first laser beam    is directed at a first location on the surface of the living subject    and the second laser beam is directed at a second location on the    surface of the living subject different from the first location.-   Clause 43. The apparatus of clause 40, wherein the reflected laser    beam is a first reflected laser beam, and further wherein the second    laser beam is configured to interact with the surface of the living    subject such that a second reflected laser beam reflects from the    surface of the living subject, and further wherein the second    reflected laser beam has different characteristics from the second    laser beam at least in part due to the interaction with the surface    of the living subject.-   Clause 44. The apparatus of clause 43, wherein the detector is    further configured to detect the second reflected laser beam that is    reflected from the surface of the living subject.-   Clause 45. The apparatus of clause 44, wherein the processor is    further configured to process the detected second reflected laser    beam to determine vibrations of the surface of the living subject.-   Clause 46. The apparatus of clause 40, wherein the second laser beam    is either visible or invisible to the human eye-   Clause 47. The apparatus of clause 39, wherein neither the emitter    nor the detector come into contact with the surface of the living    subject.-   Clause 48. A method for measuring vibrations of a surface of a    living subject comprising:    -   emitting a laser beam directed at the surface of the living        subject, wherein the laser beam is configured to interact with        the surface of the living subject such that a reflected laser        beam reflects from the surface of the living subject, and        further wherein the reflected laser beam has different        characteristics from the laser beam at least in part due to the        interaction with the surface of the living subject;    -   detecting the reflected laser beam that is reflected from the        surface of the living subject; and    -   processing the detected reflected laser beam to determine        vibrations of the surface of the living subject.-   Clause 49. The method of clause 48, wherein the processing further    outputs an audio signal that approximates a sound of the vibrations    of the surface of the living subject that would be detected if a    stethoscope was used to detect the vibrations.-   Clause 50. The method of clause 48, wherein the laser beam is either    visible or invisible to a human eye.-   Clause 51. The method of clause 50, wherein the laser beam is    invisible to the human eye and is a first laser beam, and the method    further comprises emitting a second laser beam that is visible to    the human eye, wherein the second laser beam is configured to    illuminate a point of the surface of the living subject at which the    first laser beam is directed.-   Clause 52. The method of clause 48, wherein the processing further    filters out ambient noise and light interference.-   Clause 53. The method of clause 48, further comprising outputting,    based on the processing, a visualization indicative of the    vibrations to a display of a computing device.-   Clause 54. The method of clause 48, wherein the laser beam is    modulated with a carrier frequency, and the processing further    comprises demodulating the carrier frequency from the reflected    laser beam.

Throughout the specification and claims, terms may have nuanced meaningssuggested or implied in context beyond an explicitly stated meaning.Likewise, the phrase “in one embodiment” as used herein does notnecessarily refer to the same embodiment and the phrase “in anotherembodiment” as used herein does not necessarily refer to a differentembodiment. It is intended, for example, that claimed subject matterinclude combinations of example embodiments in whole or in part.

In general, terminology may be understood at least in part from usage incontext. For example, terms, such as “and”, “or”, or “and/or,” as usedherein may include a variety of meanings that may depend at least inpart upon the context in which such terms are used. Typically, “or” ifused to associate a list, such as A, B or C, is intended to mean A, B,and C, here used in the inclusive sense, as well as A, B or C, here usedin the exclusive sense. In addition, the term “one or more” as usedherein, depending at least in part upon context, may be used to describeany feature, structure, or characteristic in a singular sense or may beused to describe combinations of features, structures or characteristicsin a plural sense. Similarly, terms, such as “a,” “an,” or “the,” again,may be understood to convey a singular usage or to convey a pluralusage, depending at least in part upon context. In addition, the term“based on” may be understood as not necessarily intended to convey anexclusive set of factors and may, instead, allow for existence ofadditional factors not necessarily expressly described, again, dependingat least in part on context.

The present disclosure is described below with reference to blockdiagrams and operational illustrations of methods and systems. It isunderstood that each block of the block diagrams or operationalillustrations, and combinations of blocks in the block diagrams oroperational illustrations, can be implemented by means of analog ordigital hardware and computer program instructions. These computerprogram instructions can be provided to a processor of a general-purposecomputer to alter its function as detailed herein, a special purposecomputer, ASIC, or other programmable data processing apparatus (e.g.,PLC), such that the instructions, which execute via the processor of thecomputer or other programmable data processing apparatus, implement thefunctions/acts specified in the block diagrams or operational block orblocks. In some alternate implementations, the functions/acts noted inthe blocks can occur out of the order noted in the operationalillustrations. For example, two blocks shown in succession can in factbe executed substantially concurrently or the blocks can sometimes beexecuted in the reverse order, depending upon the functionality/actsinvolved.

These computer program instructions can be provided to a processor of: ageneral purpose computer to alter its function to a special purpose; aspecial purpose computer; ASIC; or other programmable digital dataprocessing apparatus, such that the instructions, which execute via theprocessor of the computer or other programmable data processingapparatus, implement the functions/acts specified in the block diagramsor operational block or blocks, thereby transforming their functionalityin accordance with embodiments herein.

For the purposes of this disclosure any computer readable medium (orcomputer-readable storage medium/media) stores computer data, which datacan include computer program code (or computer-executable instructions)that is executable by a computer, in machine readable form. By way ofexample, and not limitation, a computer readable medium may comprisecomputer readable storage media, for tangible or fixed storage of data,or communication media for transient interpretation of code-containingsignals. Computer readable storage media, as used herein, refers tophysical or tangible storage (as opposed to signals) and includeswithout limitation volatile and non-volatile, removable andnon-removable media implemented in any method or technology for thetangible storage of information such as computer-readable instructions,data structures, program modules or other data. Computer readablestorage media includes, but is not limited to, RAM, ROM, EPROM, EEPROM,flash memory or other solid-state memory technology, CD-ROM, DVD, orother optical storage, magnetic cassettes, magnetic tape, magnetic diskstorage or other magnetic storage devices, or any other physical ormaterial medium which can be used to tangibly store the desiredinformation or data or instructions and which can be accessed by acomputer or processor.

Those skilled in the art will recognize that the methods and systems ofthe present disclosure may be implemented in many manners and as suchare not to be limited by the foregoing exemplary embodiments andexamples. In other words, functional elements being performed by singleor multiple components, in various combinations of hardware and softwareor firmware, and individual functions, may be distributed among softwareapplications at either the client level or server level or both. In thisregard, any number of the features of the different embodimentsdescribed herein may be combined into single or multiple embodiments,and alternate embodiments having fewer than, or more than, all of thefeatures described herein are possible.

Functionality may also be, in whole or in part, distributed amongmultiple components, in manners now known or to become known. Thus,myriad software/hardware/firmware combinations are possible in achievingthe functions, features, interfaces and preferences described herein.Moreover, the scope of the present disclosure covers conventionallyknown manners for carrying out the described features and functions andinterfaces, as well as those variations and modifications that may bemade to the hardware or software or firmware components described hereinas would be understood by those skilled in the art now and hereafter.

Furthermore, the embodiments of methods presented and described asflowcharts in this disclosure are provided by way of example in order toprovide a more complete understanding of the technology. The disclosedmethods are not limited to the operations and logical flow presentedherein. Alternative embodiments are contemplated in which the order ofthe various operations is altered and in which sub-operations describedas being part of a larger operation are performed independently.

What is claimed is:
 1. An apparatus comprising: a light; a lens positioned over the light; a switch to turn the light on or off; a clipping mechanism configured to removably attach the apparatus to a bell portion of a stethoscope; and at least one capacitive touch sensor configured to adjust a brightness of the light in response to sensing a finger of a user, wherein: the switch is accessible to a user while the apparatus is attached to the bell portion with the clipping mechanism, the apparatus is configured not to block any portion of a diaphragm of the stethoscope while the apparatus is attached to the bell portion with the clipping mechanism, the apparatus is configured to enter a sleep mode that consumes less power than a normal operating mode upon a determination that the at least one capacitive touch sensor has not sensed a presence of the finger of the user within a predetermined amount of time, and the at least one capacitive touch sensor is proximate to the lens, such that the at least one capacitive touch sensor is configured to sense a presence of the finger of the user through the lens.
 2. The apparatus of claim 1, wherein the clipping mechanism comprises flexible, rubberized plastic configured to deflect when attaching the apparatus to the stethoscope or detaching the apparatus from the stethoscope, and further wherein the flexible, rubberized plastic is configured to dampen noise from passing from the apparatus into the stethoscope.
 3. The apparatus of claim 1, wherein the clipping mechanism is configured to fit on at least two different sized bells of at least two different stethoscopes.
 4. The apparatus of claim 1, wherein the clipping mechanism comprises at least two arms configured to wrap around an outer perimeter of the bell portion.
 5. The apparatus of claim 4, wherein at least one arm of the at least two arms is operably connected to a spring, such that the at least one arm is movable when attaching the apparatus to the bell portion and the spring holds the at least one arm in place after the apparatus is attached to the bell portion.
 6. The apparatus of claim 1, wherein the light is powered by a battery and the battery is at least one of: stored directly in the apparatus; or stored in a different portion of the stethoscope than the apparatus and wherein the apparatus is electrically connected to the different portion through an electrical wire.
 7. The apparatus of claim 6, wherein the battery is stored in the different portion of the stethoscope, and the electrical wire is removably connected to the apparatus.
 8. The apparatus of claim 6, wherein the battery is stored directly in the apparatus, and the apparatus further comprises a port for removably connecting a device to the apparatus, such that the device is powered by the battery.
 9. The apparatus of claim 6, wherein the stethoscope is an electronic stethoscope comprising: a microphone configured to generate an electrical signal in response to received sound from a living subject; amplification circuitry operably coupled to the microphone and configured to amplify the electric signal generated by the microphone; and a speaker operably coupled to the amplification circuitry and configured to output the electric signal after amplification, wherein the battery powers at least one of the microphone, the amplification circuitry, or the speaker.
 10. The apparatus of claim 9, wherein the microphone is embedded into tubing connected between a diaphragm and an ear piece of the electronic stethoscope, wherein the tubing is configured to allow acoustic sound waves to travel from the diaphragm to the ear piece, and wherein the microphone does not impede the acoustic sound waves from traveling within the tubing.
 11. The apparatus of claim 6, further comprising a percussive device configured to apply a percussive force to a living subject, the percussive device comprising: a membrane having a first surface and a second surface, wherein the first surface is opposite the second surface; and a linear actuator configured to move a plunger linearly in response to application or removal of an electrical signal, wherein: the linear actuator is configured to move the plunger such that the plunger impacts the first surface of the membrane, the membrane is configured to transmit a percussive force from the first surface to the second surface as a result of the plunger impacting the first surface of the membrane, and the linear actuator is powered by the battery.
 12. The apparatus of claim 11, wherein the linear actuator comprises an electromechanical solenoid or a voice coil.
 13. The apparatus of claim 11, wherein the percussive device is configured to removably attach to the stethoscope or is incorporated into the stethoscope.
 14. The apparatus of claim 11, wherein the electrical signal is a first electrical signal, and further wherein the stethoscope is an electronic stethoscope comprising an acoustic sensor configured to generate a second electrical signal indicative of a response of a living subject to the plunger impacting the membrane and transmitting a percussive force into the living subject.
 15. The apparatus of claim 14, wherein the first electrical signal is controlled to cause a desired magnitude and duration of the percussive force.
 16. The apparatus of claim 1, wherein the apparatus is generally round in shape, and wherein the apparatus further comprises a plurality of capacitive touch sensors oriented at or near a periphery of the apparatus and configured to adjust the brightness of the light in response to the user moving the finger around the periphery of the apparatus.
 17. The apparatus of claim 1, wherein the lens is configured to focus the light in a particular direction.
 18. The apparatus of claim 1, wherein the lens is positioned on a side of the apparatus opposite the clipping mechanism.
 19. A modular electronic stethoscope apparatus comprising: an electronic stethoscope module comprising: a microphone configured to generate an electrical signal in response to received sound from a living object, amplification circuitry operably coupled to the microphone and configured to amplify the electric signal generated by the microphone, a speaker operably coupled to the amplification circuitry and configured to output the electric signal after amplification, and a power supply configured to power the amplification circuitry; a light module comprising: a light, a lens positioned over the light, a switch to turn the light on or off, a clipping mechanism configured to removably attach the light module to a bell portion of the electronic stethoscope module, and at least one capacitive touch sensor configured to adjust the brightness of the light in response to sensing the finger of a user, wherein: the switch is accessible to a user while the light module is attached to the bell portion with the clipping mechanism, the light module is configured not to block any portion of a diaphragm of the stethoscope while the light module is attached to the bell portion with the clipping mechanism, the light module is configured to enter a sleep mode that consumes less power than a normal operating mode upon a determination that the at least one capacitive touch sensor has not sensed a presence of the finger of the user within a predetermined amount of time, and the at least one capacitive touch sensor is proximate to the lens, such that the at least one capacitive touch sensor is configured to sense a presence of the finger of the user through the lens; and a percussive module comprising: a membrane having a first surface and a second surface, wherein the first surface is opposite the second surface, and a linear actuator configured to move a plunger linearly in response to application or removal of an electrical signal, wherein: the linear actuator is configured to move the plunger such that the plunger impacts the first surface of the membrane, the membrane is configured to transmit a percussive force from the first surface to the second surface as a result of the plunger impacting the first surface of the membrane, and the percussive module is configured to removably attach to the electronic stethoscope module.
 20. An apparatus comprising: a light; a lens positioned over the light; a switch to turn the light on or off; a clipping mechanism configured to removably attach the apparatus to a tubing portion of a stethoscope; and at least one capacitive touch sensor configured to adjust a brightness of the light in response to sensing a finger of a user, wherein: the switch is accessible to a user while the apparatus is attached to the tubing portion with the clipping mechanism, and the apparatus is configured not to block any portion of a diaphragm of the stethoscope while the apparatus is attached to the tubing portion with the clipping mechanism, the apparatus is configured to enter a sleep mode that consumes less power than a normal operating mode upon a determination that the at least one capacitive touch sensor has not sensed a presence of the finger of the user within a predetermined amount of time, and the at least one capacitive touch sensor is proximate to the lens, such that the at least one capacitive touch sensor is configured to sense a presence of the finger of the user through the lens. 